Role of intraoperative squash smear cytology as a diagnostic modality in lipoma of quadrigeminal cistern

Address for correspondence: Prof. Ravindra K Saran Department of Pathology, Academic Block, G B Pant Hospital, Jawaharlal Nehru Marg New Delhi - 110 002 India ravindraksaran@hotmail.com

Journal of Neurosciences in Rural Practice

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Abstract

ABSTRACT

Quadrigeminal lipoma is a rare tumor that has been categorized as developmental malformation rather than a hamartoma or true neoplasm, due to its origin from abnormal persistence and mal‑differentiation of meninx primitiva during the development of the subarachnoid cisterns. Reported admixture of adipose tissue with heterotopic elements also supports a developmental origin. Quadrigeminal lipomas are frequently asymptomatic and detected incidentally. Though a favorable clinical course is usually expected, recurrences may occur due to partial removal of lesions in close relation to vital structure. We describe the role of intraoperative squash smear cytology as a diagnostic aid in quadrigeminal cistern lipoma and an alternative to frozen sections that are technically difficult to obtain due to presence of lobules of fibro‑adipose tissue. With radiological correlation, squash cytology can be an economical method for intraoperative diagnosis, pending subsequent histopathological confirmation.

Keywords

Cytology

lipoma

quadrigeminal

prognosis

squash

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Conflicts of interest

None declared

REFERENCES

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[1] Kiymaz N, Cirak B, . Central nervous system lipomas. Tohoku J Exp Med. 2002;198:203-6.
[Google Scholar]

[2] Truwit C. L., Barkovich A. J., . Pathogenesis of intracranial lipoma: An MR study in 42 patients. AJNR Am J Neuroradiol. 1990;11:665-74.
[Google Scholar]

[3] Gómez-Gosálvez F. A., Menor-Serrano F, Téllez de Meneses-Lorenzo M, Aleu Pérez-Gramunt M, Sala-Sánchez A. G., Rubio-Soriano A, et al. . Intracranial lipomas in paediatrics: A retrospective study of 20 patients. Rev Neurol. 2003;37:515-21.
[Google Scholar]

[4] Yilmazlar S, Kocaeli H, Aksoy K, . Quadrigeminal cistern lipoma. J Clin Neurosci. 2005;12:596-9.
[Google Scholar]

[5] Nikaido Y, Imanishi M, Monobe T, . Lipoma in the quadrigeminal cistern-case report. Neurol Med Chir (Tokyo). 1995;35:175-8.
[Google Scholar]

[6] Kim J. Y., Lee T. J., Chi J. G., . Congenital quadrigeminal lipoma with osteocartilagenous element. A case report. J Korean Med Sci. 1996;11:537-9.
[Google Scholar]

[7] Ono J, Ikeda T, Imai K, Mano T, Matsuoka T, Nagai T, et al. . Intracranial lipoma of the quadrigeminal region associated with complex partial seizures. Pediatr Radiol. 1998;28:729-31.
[Google Scholar]

[8] Bakshi R, Shaikh Z. A., Kamran S, Kinkel P. R., . MRI findings in 32 consecutive lipomas using conventional and advanced sequences. J Neuroimaging. 1999;9:134-40.
[Google Scholar]

[9] Ichikawa T, Kumazaki T, Mizumura S, Kijima T, Motohashi S, Gocho G, . Intracranial lipomas: Demonstration by computed tomography and magnetic resonance imaging. J Nippon Med Sch. 2000;67:388-91.
[Google Scholar]