Cytomorphologic and clinicoradiologic analysis of primary nonhematologic central nervous system tumors with positive cerebrospinal fluid

Ho, Cheng Ying; VandenBussche, Christopher; Huppman, Alison R.; Chaudhry, Rabia; Ali, Syed Z.

doi:10.1002/cncy.21502

Cited by 21 publications

(22 citation statements)

References 19 publications

(29 reference statements)

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“…The results of our retrospective study are in line with previous reports . Since the publication by Bigner in the 1980s, it has been established that MB cells display distinctive features, including medium‐to‐large size, a high nuclear:cytoplasmic ratio, cells arranged either singly or in fragments, and shedding of immature neoplastic cells, often in molded clusters.…”

Section: Discussionsupporting

confidence: 91%

“…The results of our retrospective study are in line with previous reports. 2,[10][11][12] Since the publication by Bigner in the 1980s, it has been established that MB cells display distinctive features, including medium-to-large size, a high nuclear:cytoplasmic ratio, cells arranged either singly or in fragments, 10 and shedding of immature neoplastic cells, often in molded clusters. Although they were classically described as small round blue cells, actually, MB tumor cells are large (up to about 20 lm) 11 and are characterized by scanty, transparent, and poorly defined cytoplasm.…”

Section: Discussionmentioning

confidence: 99%

“…1 Primary central nervous system (CNS) tumors uncommonly involve leptomeninges overall, and a 2% incidence of neoplastic meningitis in primary brain tumors is reported in the literature. 2 Nevertheless, leptomeningeal involvement is a common problem in pediatric CNS tumors and is present in from 20% to 30% of children who have primary CNS tumors. 3 Medulloblastoma (MB) is an aggressive, high-grade, embryonal, cerebellar tumor composed of undifferentiated or poorly differentiated cells (the so-called small blue cells) that arises mostly in children during infancy or early puberty, with a peak in the first decade of life, 4 whereas adult cases are rare, with an incidence of about 0.5 per million.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Young investigator challenge: Cytomorphologic analysis of cerebrospinal fluid in 70 pediatric patients with medulloblastoma and review of the literature focusing on novel diagnostic and prognostic tests

Damiani

Suciu

Andreiuolo

et al. 2015

Cancer Cytopathology

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Young investigator challenge: Cytomorphologic analysis of cerebrospinal fluid in 70 pediatric patients with medulloblastoma and review of the literature focusing on novel diagnostic and prognostic tests

Damiani

Suciu

Andreiuolo

et al. 2015

Cancer Cytopathology

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“…In our study we did not find any case of primary brain tumor with metastasis to CSF. However, other studies[ 19 20 ] have seen a predominance (86%) of pediatric brain tumors with metastasis to CSF.…”

Section: Discussionmentioning

confidence: 94%

Neoplastic meningitis: A study from a Tertiary Care Hospital from coastal India

Suresh

Kini

Basavaiah

et al. 2018

J Cytol

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Introduction:Neoplastic involvement of cerebrospinal fluid (CSF) secondary to known or unknown primaries elsewhere is a poor prognostic factor and is equivalent to stage IV disease.Aim:The aim of the study is to analyse the cytological features of neoplastic meningitis in a tertiary care center.Materials and Methods:A retrospective study of 400 consecutive CSF samples was done in the cytology laboratory of our hospital. The fluid obtained by spinal tap was sent for microbiological, biochemical and cytological evaluation. Smears that showed the presence of malignant cells were included in this study.Results:Out of 400 cases, 36 (9%) showed neoplastic meningitis. Of which, 13 cases (36%) revealed leukemic infiltration, 2 (6%) lymphomatous infiltration and 21 (58%) carcinomatous meningitis. The leukemia cases included seven cases of acute lymphoblastic leukemia and six cases of acute myeloid leukemia. Among the carcinomatous meningitis cases, eight were metastasis from carcinoma breast, six from lung carcinoma and one each from malignancies of gallbladder, stomach and retinoblastoma. Four cases were metastatic adenocarcinoma from unknown primary. Pleocytosis was a significant finding seen in 58% cases (n = 21). Elevated protein and hypoglychorrhachia was noted in 68% cases (n = 18).Conclusion:A combined diagnostic approach including biochemical, microbiological and pathological evaluation was useful in eliminating infectious meningitis and confirming neoplastic meningitis in these cases. Cytology should be performed on cerebrospinal specimens from all patients with known or suspected malignancy with meningismus. Detection of malignant cells on cytological examination of CSF is the diagnostic gold standard for neoplastic meningitis.

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“…For example, Singh et al ( 10 ) summarized cytological characteristics of tumor appearance patterns for breast carcinoma, ovarian carcinoma, malignant melanoma among others ( 10 ). Ho et al ( 11 ) summarized cytomorphological characteristics of primary CNS tumors in the CSF. Rao et al ( 12 ) reported cytopathological characteristics of CSF for 15 patients with breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Macrophages in Giemsa-stained cerebrospinal fluid specimens predict carcinomatous meningitis

et al. 2020

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Carcinomatous meningitis is a condition in which tumor cells spread to the subarachnoid space. Leukocyte counting and typing of cerebrospinal fluid (CSF) cell components are performed manually or using flow cytometry. However, a detailed analysis of these variables using cytological specimens has not yet been reported. The present study analyzed cytological specimens using Giemsa staining and whole slide imaging with computer-assisted image analysis (CAIA) to clarify the characteristics of the leukocyte population in CSF, especially in carcinomatous meningitis. Manual evaluation was performed using 280 Giemsa-stained cytological CSF specimens. For 49 samples, CAIA was used for the whole area of Papanicolaou (Pap) staining, and Giemsa-stained specimens of the same samples were imaged using a virtual slide scanner. The nuclear morphology of the leukocytes was assessed, and the total leukocyte and leukocyte subset (lymphocytes, neutrophils and macrophages) counts were evaluated. Then, the number and percentage of each leukocyte subset population were evaluated. The total leukocyte count was significantly higher in Giemsa-stained specimens compared with in Pap-stained specimens. The percentage of macrophages was significantly higher in samples from patients with non-hematological tumors compared with in samples from patients without tumors, which was confirmed by manual evaluation of the specimens. In addition, the cut-off value of the percentage of macrophages that could discriminate between the tumor history negative cases and cytologically tumor positive cases was determined, revealing that a higher proportion of macrophages reflected the existence of atypical/malignant epithelial tumor cells in CSF samples. Thus, atypical cell screening and analysis of the background characteristics of the leukocyte population should be the focus of cytological specimen screening, especially not to miss carcinomatous meningitis.

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Cytomorphologic and clinicoradiologic analysis of primary nonhematologic central nervous system tumors with positive cerebrospinal fluid

Cited by 21 publications

References 19 publications

Young investigator challenge: Cytomorphologic analysis of cerebrospinal fluid in 70 pediatric patients with medulloblastoma and review of the literature focusing on novel diagnostic and prognostic tests

Young investigator challenge: Cytomorphologic analysis of cerebrospinal fluid in 70 pediatric patients with medulloblastoma and review of the literature focusing on novel diagnostic and prognostic tests

Neoplastic meningitis: A study from a Tertiary Care Hospital from coastal India

Macrophages in Giemsa-stained cerebrospinal fluid specimens predict carcinomatous meningitis

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