Cytologic diagnosis of a metastatic oligodendroglioma in a pleural effusion - A case report
Cytologic diagnosis of a metastatic oligodendroglioma in a pleural effusion - A case report
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DOI：
10.1159/000326011
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发表时间：
2006-09-01
期刊：
影响因子：
1.8
通讯作者：
Tsai, Ming-Dar
中科院分区：
文献类型：
--
作者：
Lee, Chin-Cheng;Jiang, Jiunn-Song;Tsai, Ming-Dar
背景少突胶质细胞瘤神经外转移极为罕见，主要通过活检或尸检确诊，偶尔通过细针细胞学检查确诊。我们报告一例转移性少突胶质细胞瘤，经胸腔积液细胞学检查确诊。这种诊断以前没有报道过。病例44岁的女性在左额叶的少突胶质细胞瘤手术后7年出现贫血和双侧胸腔积液。细胞学检查胸腔积液可见非典型多角形细胞聚集，胞核呈圆形、深染，胞浆稀少、颗粒状，可见刘氏染色和巴氏染色及细胞块。免疫组织化学染色显示肿瘤细胞对胶质纤维酸性蛋白、S-100和寡核苷酸的抗体呈阳性反应。胸膜活检证实细胞学诊断为胸腔积液。1个月后发现右侧肱骨和股骨的病理性骨折，标本还显示骨组织中有浸润性的少突胶质细胞瘤细胞。细针细胞学检查可以为不同器官的颅外转移性少突胶质细胞瘤提供可靠和快速的检测方法。
Background Extraneural metastasis of oligodendroglioma is extremely rare and is diagnosed primarily by biopsy or autopsy and very occasionally by fine needle cytologic examination. We report a case of metastatic oligodendroglioma diagnosed by cytologic examination of a pleural effusion. Such a diagnosis has not been reported before.Case 44-year-old woman developed anemia and bilateral pleural effusion 7 years after an operation for an oligodendroglioma, over the left frontal lobe. Cytologic examination of the pleural effusion showed aggregates of atypical polygonal cells containing round, hyperchromatic nuclei and scanty, granular cytoplasm in Liu's and Papanicolaou stain and cell blocks. Immunohistochemical staining of the tumor cells revealed a positive reaction for antibodies to glial fibrillary acidic protein, S-100 and Olig2. Pleural biopsy confirmed the cytologic diagnosis of pleural effusion. A pathologic fracture of the right humeral and femoral hones was noted I month later, and the specimen also showed infiltrating oligodendroglioma cells in bone tissue.Conclusion To the best of our knowledge, this is the first metastatic oligodendroglioma diagnosed by pleural cytology. Fine needle cytology can provide a reliable and rapid way to detect an extracranial metastatic oligodendroglioma in different organs.