Context:Intraoperative cytology and frozen section play an important role in the diagnosis of neurosurgical specimens. There are limitations in both these procedures but understanding the errors and pitfalls may help in increasing the diagnostic yield.Aims:To find the diagnostic accuracy of intraoperative cytology and frozen section for central and peripheral nervous system (PNS) lesions and analyze the errors, pitfalls, and limitations in these procedures.Settings and Design:Eighty cases were included in this prospective study in a span of 1.5 years.Materials and Methods:The crush preparations and the frozen sections were stained with hematoxylin and eosin method. The diagnosis of crush smears and the frozen sections were compared with the diagnosis in the paraffin section, which was considered as the gold standard.Statistical Analyses Used:Diagnostic accuracy, sensitivity, and specificity.Results:The diagnostic accuracy of crush smears was 91.25% with a sensitivity of 95.5% and specificity of 100%. In the frozen sections, the overall diagnostic accuracy was 95%, sensitivity was 96.8%, and specificity was 100%. The categories of pitfalls noted in this study were categorization of spindle cell lesions, differentiation of oligodendroglioma from astrocytoma in frozen sections, differentiation of coagulative tumor necrosis of glioblastoma multiforme (GBM) from the caseous necrosis of tuberculosis, grading of gliomas in frozen section, and differentiation of the normal granular cells of the cerebellum from the lymphocytes in cytological smears.Conclusions:Crush smear and frozen section are complimentary procedures. When both are used together, the diagnostic yield is substantially increased.

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Background: The diagnosis of skin adnexal tumors is usually based on histopathology. However, fine-needle aspiration cytology (FNAC) can be of great help and shows a high degree of correlation to the final diagnosis. It is helpful in many situations where skin lesions are a manifestation of certain systemic syndromes and aids to the formation of precise treatment plans. Materials and Methods: This prospective study was carried out to assess the diagnosis of skin adnexal tumors based on FNAC and their comparison with histopathological diagnoses. There were 14 patients with FNAC and histopathological follow-up in whom a final diagnosis of skin adnexal tumor was made. The results of FNAC were compared with histopathological diagnoses for complete correlation, partial correlation (cases where an FNAC diagnosis of skin adnexal tumor was made but a precise diagnosis of the subtype was not possible) or no correlation (where FNAC failed to diagnose a skin adnexal tumor). Results: Among the 14 cases of skin adnexal tumor, there was total correlation between the FNAC diagnosis and final histopathological diagnosis in 8 cases (57.1%) and a partial correlation in 4 cases (28.5%). There was no correlation of the FNAC diagnosis with the histopathological diagnosis in only 2 cases (14.3%). Conclusions: FNAC is very useful in making a diagnosis of skin adnexal tumors and helps in the management of the patient.

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Ependymoblastoma is a rare, highly malignant brain tumour considered by most to be a subtype of primitive neuroectodermal tumour manifesting in young children. The authors present an unusual case of ependymoblastoma occurring in an 18-year-old female, one of the oldest patients reported with this tumour. The crush smears were highly cellular comprising singly scattered small, round immature cells with fine granular chromatin. The paraffin sections showed a tumour composed of uniform, small-sized, primitive cells forming well defined multi-layered rosettes with prominent mitoses. The tumour cells exhibited diffuse Vimentin and focal glial fibrillary acidic protein reactivity. A few cells showed S-100 reactivity. The patient underwent radiotherapy following complete tumour debulking but, succumbed to the disease within 2 months of diagnosis.