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glioblastomamultiforme are high - grade malignant glial tumors of central nervous system ( cns ) with divergent differentiations . according to world health organization nomenclature , anaplastic glial tumors with necrosis , astrocytic , and oligodendroglial components should be labeled as 
. absence of necrosis and presence of malignant glial and oligodendroglial components , makes the tumor to be labeled as  anaplastic oligoastrocytoma  .
these procedures can be used as supplementary and complementary procedures to frozen section in intraoperative rapid diagnosis of cns lesions .
we present a rare case report of glioblastoma with sarcomatous and oligodendroglial components , diagnosed by squash and touch cytology of open biopsy .
a 60-year - old woman presented with left upper and lower limb weakness since 10 days , and headache and vomiting since 1 month . on general physical examination , no organomegaly or any lymphadenopathy was seen .
on contrast - enhanced computed tomography , examination of head , a disc - enhancing lesion [ figure 1 ] with edema was seen in the right posterior frontal region . per operatively
contrast - enhanced computed tomography examination of head displaying , a disc - enhancing lesion with edema imprint smears were prepared from tumor by touching the slide on tumor surface , and squash smears were prepared by taking a part of tumor through scalpel and keeping it between two slides and moving one slide over another , so that a thick paste comes out .
microscopic examination revealed glial tissue with pleomorphic nuclei , areas of necrosis , endothelial proliferation , and areas of sarcomatous change [ figure 2 ] displaying interlacing bundles of spindle cells with pleomorphism .
areas of oligodendroglial tissue with small dark round nuclei and fine chromatin pattern were evident [ figure 3 ] . a presumptive diagnosis of  glioblastoma with sarcomatous and oligodendroglial component  was made .
reticulin stain positivity [ figure 4 ] was employed to confirm the diagnosis of sarcomatous component .
hematoxylin and eosin - stained squash smear , revealing tight bundles of spindle cells imprint pap - stained smear displays a round dark nuclei ( arrow head ) and a pleomorphic nuclei ( black arrow ) hematoxylin and eosin - stained section displays a glial lesion with oligodendroglial component ( arrow head )
intraoperative cytology has gained immense popularity and usefulness in diagnosis of cns lesions , subsequent to squash technique introduction in early 1930s .
lesions with soft tissue consistency , such as pituitary adenomas , medulloblastomas , and metastatic carcinoma pose little diagnostic problems compared with firm tissue lesions .
gliosarcoma is a glioblastoma 's variant that is characterized by biphasic pattern with areas of glial and mesenchymal differentiation .
the common lines of differentiation of sarcomatous components are the fibrosarcomatous and malignant fibrous histiocytoma - like types .
deposition of abundant collagen andreticulin fibers in spindle cell component by means of masson trichrome and reticulin staining , respectively , is helpful in clinching the diagnosis of gliosarcoma .
this case has to be differentiated from an oligodendroglial tumor with desmoplastic response . in the present case , separate nodule formation , predominantly composed of spindle cells is suggestive of neoplastic nature and deposition of reticulin fibers in the spindle cell components
similar types of reports were mentioned by feign et al . and pasquier et al .
due to its extreme rare occurrence , prognostication of tumor and response to chemotherapy regimen needs to be evaluated .
intraoperative diagnosis of brain tumors entails frozen section and intraoperative cytology , both of which provide rapid intraoperative pathologic consultation to the neurosurgeons .
cytology samples evaluate much wider areas , which is crucial , as astrocytomas may display different grades in different areas and at different depths .
furthermore , it is easier to obtain excellent touch and squash preparation cytology than to have a high - quality brain tissue frozen section .
a good cytological preparation of brain displays high cellularity , crisp nuclear and cytoplasmic details , and occasionally the tissue architecture .
however , frozen sections on brain tissue may develop many artifacts , including those produced by the ice crystals and water logging in the tissues . as a result
cytological evaluation has further advantages of being inexpensive , simple , and quicker than frozen section . in conclusion ,
glioblastoma , the most frequent primary brain tumor and the most malignant neoplasm , can have the most heterogeneous morphological presentation . along with classical morphological features , areas of oligodendroglial component and mesenchymal differentiation 
 may be seen . 
 the present case was a rare case of glioblastoma presenting with sarcomatous and oligodendroglial components . 
 the case was diagnosed intraoperatively by squash and touch cytology and later on confirmed by histopathological study .