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Pleomorphic xanthoastrocytoma (PXA) is WHO grade II tumor representing less than 1% of all astrocytic tumors. It displays cellular atypia and pleomorphism to such an extent that it can be misdiagnosed as a high grade glioma thereby posing a diagnostic challenge especially during intraoperative squash preparations. The present case is a 16-yr-old boy with history of seizures and CT Brain showed a mass located in the right temporal lobe. The intraoperative cytological diagnosis of low grade glioneuronal tumor was rendered.Pleomorphic xanthoastrocytoma was confirmed on histopathology and immunohistochemistry. This challenging case highlights the salient cytomorphologic features of this tumor along with differential diagnosis.

Intra-operative squash cytodiagnosis of pleomorphic xanthoastrocytoma : A diagnostic challenge