Cytopathology of neoplastic meningitis: A series of 66 cases from a tertiary care center.
Cytopathology of neoplastic meningitis: A series of 66 cases from a tertiary care center.
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DOI：
10.4103/1742-6413.114212
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发表时间：
2013
期刊：
影响因子：
1.9
通讯作者：
Jain D
中科院分区：
文献类型：
--
作者：
Singh G;Mathur SR;Iyer VK;Jain D
肿瘤性脑膜炎（NM）是一种以转移性癌累及软脑膜为特征的疾病。由于脑膜转移而在脑脊液（CSF）中检测到脱落的恶性细胞通常与不同的神经系统表现相关。在这项回顾性研究中，所有病例的NM诊断脑脊液样本超过20年的时间在三级保健转诊中心，细胞形态学特征进行了审查。66例NM被确定，其中36例已经确定诊断为恶性肿瘤，而30例患者以前没有已知的肿瘤。前一组中最常见的原发灶是乳腺，其次是卵巢。乳腺和肺肿瘤呈单细胞型，细胞自食，中等程度的胞浆和圆形的核。在卵巢原叶中可见乳头状结构和细胞质空泡化。恶性黑色素瘤可见黑色素沉着。脑脊液细胞学检查是诊断NM的重要手段。细胞形态学特征有助于诊断和预测原发部位。正确识别这种情况是重要的，因为它具有治疗和预后意义。
Neoplastic meningitis (NM) is a condition characterized by leptomeningeal involvement by metastatic carcinoma. Detection of exfoliated malignant cells in cerebrospinal fluid (CSF) due to meningeal metastasis is frequently associated with diverse neurologic presentations. In this retrospective study of all cases of NM diagnosed in CSF samples over a 20-year period at a tertiary care referral center, the cytomorphologic features were reviewed. Sixty six cases of NM were identified of which 36 already had an established diagnosis of malignancy while in 30 patients, there was no previously known tumor. The most common known primary in the former group was breast followed by ovary. Single cell pattern, cellular cannibalism, moderate cytoplasm and rounded nuclei were seen in breast and lung tumors. Papillary architecture and cytoplasmic vacuolation were seen in the ovarian primaries. Melanin pigment was seen in malignant melanoma. CSF cytology is an important tool for diagnosis of NM. Cytomorphologic features helped in diagnosis and for prediction of the primary site. Correct identification of this condition is important as it has therapeutic and prognostic implications.