Cytologic Characteristics of Meningeal Carcinomatosis

Abstract

We conclude that in using common antibodies, such as carcinoembryonic antigen and epithelial membrane antigen, the sensitivity of the cytologic diagnosis of meningeal carcinomatosis increases, and that previously Papanicolaou-stained preparations are suitable for immunocytochemical studies.

Metastatic Squamous Cell Carcinoma in Cerebrospinal Fluid: Why a Rare Diagnosis on Cytology?

“…Other challenges faced by the cytopathologist in making a definite diagnosis of malignant cells in CSF are: bland cellular morphology, presence of individual cells, rarity of loose clusters (in contrast to cell balls in fluids from other body cavities), and frequent association with pia arachnoid mesothelial and inflammatory cells [1]. The problem is compounded in cases of squamous cell carcinoma as cytologic examination of CSF reveals a limited number of carcinoma cells with minimal pleomorphism [6,13,14]. Cytology most often shows atypical mononuclear cells with round, hyperchromatic cells and occasionally well-defined refractile cytoplasmic outline [12].…”

“…The characteristic malignant keratinizing squamous cell as described in an occasional case report is rarely seen in CSF [10,15]. Immunocytochemistry has been advocated to improve the diagnostic accuracy of the test [13]. However, not everyone agrees that immunocytochemistry increases the sensitivity of cytologic diagnosis of malignant neoplasm in CSF [16].…”

“…However, not everyone agrees that immunocytochemistry increases the sensitivity of cytologic diagnosis of malignant neoplasm in CSF [16]. This results in rendering an inconclusive diagnosis and necessitates repeated lumbar punctures in a clinically suspected case of squamous cell carcinoma with meningeal carcinomatosis [6,13,17]. The associated increased risk of morbidity and patient discomfort often discourages clinicians from using this modality to form a definitive diagnosis.…”

Metastatic Squamous Cell Carcinoma in Cerebrospinal Fluid: Why a Rare Diagnosis on Cytology?

“…Other challenges faced by the cytopathologist in making a definite diagnosis of malignant cells in CSF are: bland cellular morphology, presence of individual cells, rarity of loose clusters (in contrast to cell balls in fluids from other body cavities), and frequent association with pia arachnoid mesothelial and inflammatory cells [1]. The problem is compounded in cases of squamous cell carcinoma as cytologic examination of CSF reveals a limited number of carcinoma cells with minimal pleomorphism [6,13,14]. Cytology most often shows atypical mononuclear cells with round, hyperchromatic cells and occasionally well-defined refractile cytoplasmic outline [12].…”

“…The characteristic malignant keratinizing squamous cell as described in an occasional case report is rarely seen in CSF [10,15]. Immunocytochemistry has been advocated to improve the diagnostic accuracy of the test [13]. However, not everyone agrees that immunocytochemistry increases the sensitivity of cytologic diagnosis of malignant neoplasm in CSF [16].…”

“…However, not everyone agrees that immunocytochemistry increases the sensitivity of cytologic diagnosis of malignant neoplasm in CSF [16]. This results in rendering an inconclusive diagnosis and necessitates repeated lumbar punctures in a clinically suspected case of squamous cell carcinoma with meningeal carcinomatosis [6,13,17]. The associated increased risk of morbidity and patient discomfort often discourages clinicians from using this modality to form a definitive diagnosis.…”

Isolated Meningeal Recurrence of Transitional Cell Carcinoma of the Bladder

“…Meningeal carcinomatosis (MC) occurs in 1-18% of patients with solid tumours, most commonly carcinomas of the breast and lung or melanomas [1,2,3]. Presenting neurological features depend on whether the cerebral hemispheres, cranial nerves, spinal cord or nerve roots are involved [4].…”

Diagnosis of Metastatic Tumors in Cerebrospinal Fluid Samples Using Thin-Layer Cytology

“…[1][2][3][4][5] The most frequent neoplasms were breast (ductal and lobular) and lung carcinoma (adenocarcinoma and small cell carcinoma). Three cases in the lymphoreticular system were lymphomas of T-cell origin and 1 chronic myelocytic leukemia (CML).…”

Metastatic Squamous Cell Carcinoma in Cerebrospinal Fluid: Why a Rare Diagnosis on Cytology?

“…Other challenges faced by the cytopathologist in making a definite diagnosis of malignant cells in CSF are: bland cellular morphology, presence of individual cells, rarity of loose clusters (in contrast to cell balls in fluids from other body cavities), and frequent association with pia arachnoid mesothelial and inflammatory cells [1]. The problem is compounded in cases of squamous cell carcinoma as cytologic examination of CSF reveals a limited number of carcinoma cells with minimal pleomorphism [6,13,14]. Cytology most often shows atypical mononuclear cells with round, hyperchromatic cells and occasionally well-defined refractile cytoplasmic outline [12].…”

“…The characteristic malignant keratinizing squamous cell as described in an occasional case report is rarely seen in CSF [10,15]. Immunocytochemistry has been advocated to improve the diagnostic accuracy of the test [13]. However, not everyone agrees that immunocytochemistry increases the sensitivity of cytologic diagnosis of malignant neoplasm in CSF [16].…”

“…However, not everyone agrees that immunocytochemistry increases the sensitivity of cytologic diagnosis of malignant neoplasm in CSF [16]. This results in rendering an inconclusive diagnosis and necessitates repeated lumbar punctures in a clinically suspected case of squamous cell carcinoma with meningeal carcinomatosis [6,13,17]. The associated increased risk of morbidity and patient discomfort often discourages clinicians from using this modality to form a definitive diagnosis.…”

Isolated Meningeal Recurrence of Transitional Cell Carcinoma of the Bladder

“…Meningeal carcinomatosis (MC) occurs in 1-18% of patients with solid tumours, most commonly carcinomas of the breast and lung or melanomas [1,2,3]. Presenting neurological features depend on whether the cerebral hemispheres, cranial nerves, spinal cord or nerve roots are involved [4].…”

Diagnosis of Metastatic Tumors in Cerebrospinal Fluid Samples Using Thin-Layer Cytology

“…[1][2][3][4][5] The most frequent neoplasms were breast (ductal and lobular) and lung carcinoma (adenocarcinoma and small cell carcinoma). Three cases in the lymphoreticular system were lymphomas of T-cell origin and 1 chronic myelocytic leukemia (CML).…”

Metastatic Squamous Cell Carcinoma in Cerebrospinal Fluid: Why a Rare Diagnosis on Cytology?

“…Other challenges faced by the cytopathologist in making a definite diagnosis of malignant cells in CSF are: bland cellular morphology, presence of individual cells, rarity of loose clusters (in contrast to cell balls in fluids from other body cavities), and frequent association with pia arachnoid mesothelial and inflammatory cells [1]. The problem is compounded in cases of squamous cell carcinoma as cytologic examination of CSF reveals a limited number of carcinoma cells with minimal pleomorphism [6,13,14]. Cytology most often shows atypical mononuclear cells with round, hyperchromatic cells and occasionally well-defined refractile cytoplasmic outline [12].…”

“…The characteristic malignant keratinizing squamous cell as described in an occasional case report is rarely seen in CSF [10,15]. Immunocytochemistry has been advocated to improve the diagnostic accuracy of the test [13]. However, not everyone agrees that immunocytochemistry increases the sensitivity of cytologic diagnosis of malignant neoplasm in CSF [16].…”

“…However, not everyone agrees that immunocytochemistry increases the sensitivity of cytologic diagnosis of malignant neoplasm in CSF [16]. This results in rendering an inconclusive diagnosis and necessitates repeated lumbar punctures in a clinically suspected case of squamous cell carcinoma with meningeal carcinomatosis [6,13,17]. The associated increased risk of morbidity and patient discomfort often discourages clinicians from using this modality to form a definitive diagnosis.…”

Isolated Meningeal Recurrence of Transitional Cell Carcinoma of the Bladder

“…Meningeal carcinomatosis (MC) occurs in 1-18% of patients with solid tumours, most commonly carcinomas of the breast and lung or melanomas [1,2,3]. Presenting neurological features depend on whether the cerebral hemispheres, cranial nerves, spinal cord or nerve roots are involved [4].…”

Diagnosis of Metastatic Tumors in Cerebrospinal Fluid Samples Using Thin-Layer Cytology

“…[1][2][3][4][5] The most frequent neoplasms were breast (ductal and lobular) and lung carcinoma (adenocarcinoma and small cell carcinoma). Three cases in the lymphoreticular system were lymphomas of T-cell origin and 1 chronic myelocytic leukemia (CML).…”