Cytopathology of neoplastic meningitis: A series of 66 cases from a tertiary care center

Gurdeep, Singh; Mathur, Sandeep; Iyer, V. K.; Jain, Deepali

doi:10.4103/1742-6413.114212

Cited by 13 publications

(14 citation statements)

References 25 publications

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“…Published data on cytology of metastatic breast carcinoma to CSF are limited . In our study, the CSF samples were stained using both Papanicolaou and Diff‐Quik stains, and both stains proved to be equally diagnostic.…”

Section: Discussionmentioning

confidence: 77%

“…. Collection of at least 10 mL of CSF, immediate processing, and analyses of at least two specimens can improve accuracy of CSF in MC .…”

Section: Discussionmentioning

confidence: 99%

“…Two other studies have examined the cytomorphological features of metastatic breast carcinoma to CSF . Both studies also described single or small clusters of tumor cells with single to multiple nucleoli.…”

Section: Discussionmentioning

confidence: 99%

“…. Only a few reports have detailed cytopathological characteristics of metastatic breast carcinoma in CSF . This retrospective study was primarily aimed at studying the cytopathological features of metastatic breast carcinoma in CSF on Cytospin preparations.…”

mentioning

confidence: 99%

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Metastatic Breast Carcinoma in Cerebrospinal Fluid: A Cytopathological Review of 15 Cases

et al. 2017

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The incidence of metastatic carcinoma to the meninges ("meningeal carcinomatosis" [MC]) is increasing due to longer survival of patients and improved imaging techniques. Currently, MC is best diagnosed by cytopathological evaluation of cerebrospinal fluid (CSF). Breast primaries are the commonest cause of MC; although cytopathological features thereof have not been, as yet, fully characterized. In this study of meningeal mammary carcinomatosis, relevant clinicopathological data and archived cytopathological preparations of all "suspicious" and "positive" CSF specimens (1992-2015), from patients with a history of breast carcinoma, were retrieved and reviewed. Twenty-three "positive" CSF specimens, derived from 15 patients formed the basis of this study. All specimens were processed as Cytospin preparations, and stained by Papanicolaou and Diff-Quik techniques. All patients were female, with a mean age of 57 (range: 32-85) years. Mean interval between initial diagnosis of breast carcinoma and "positive" CSF was 32 (range 6-84) months. All 23 specimens (100%) were "cellular" (>10 carcinoma cells). Eighteen (78%) specimens showed only isolated nonclustered cells, and 5 (22%) specimens showed both cell clusters and isolated cells. In most "positive" cases, metastatic breast carcinoma cells showed variation in cell size, with hyperchromatic nuclei, irregular nuclear membranes, prominent nucleoli and cytoplasmic vacuolization. The background in some CSF samples showed red blood cells and fibrin admixed with rare lymphocytes and histiocytes. One specimen showed necrotic debris. Papanicolaou and Diff-Quik-stained Cytospin preparations were equally diagnostic, as the aforementioned findings were present in both types of preparation.

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Section: Discussionmentioning

confidence: 77%

“…. Collection of at least 10 mL of CSF, immediate processing, and analyses of at least two specimens can improve accuracy of CSF in MC .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Metastatic Breast Carcinoma in Cerebrospinal Fluid: A Cytopathological Review of 15 Cases

et al. 2017

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“…On the other hand, in terms of cytological specimens, the features of malignant cells are the main focus of CSF cytology. 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.…”

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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Cytopathological differential diagnosis of malignant tumor cells in the cerebrospinal fluid: A retrospective analysis

Ruotolo,

Maffei,

Sabbatino

et al. 2023

Diagnostic Cytopathology

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Leptomeningeal metastasis is the spread of cancer to the leptomeninges and subarachnoid space and represents a dreadful complication of cancer. The most commonly responsible neoplasms are high‐grade lymphomas, leukemias, and some solid tumors, chiefly breast and lung cancer as well as melanoma. Herein we report our ten‐year retrospective experience on 715 cases of cerebrospinal fluid cytology, 21 (2.9%) of which were positive for leptomeningeal metastasis. Sample collection and processing, clinical history, interdisciplinary dialog, and ancillary techniques such as immunocytochemistry and flow cytometry are all fundamental in reaching the correct diagnosis and thus optimally caring for patients with leptomeningeal metastasis.

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Cytopathology of neoplastic meningitis: A series of 66 cases from a tertiary care center

Cited by 13 publications

References 25 publications

Metastatic Breast Carcinoma in Cerebrospinal Fluid: A Cytopathological Review of 15 Cases

Metastatic Breast Carcinoma in Cerebrospinal Fluid: A Cytopathological Review of 15 Cases

Macrophages in Giemsa-stained cerebrospinal fluid specimens predict carcinomatous meningitis

Cytopathological differential diagnosis of malignant tumor cells in the cerebrospinal fluid: A retrospective analysis

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