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

Sioutopoulou, Despina; Kampas, L.; Gerasimidou, Domniki; Valeri, R; Boukovinas, Ioannis; Tsavdaridis, D.; Destouni, Chariklia T

doi:10.1159/000325511

Cited by 17 publications

(18 citation statements)

References 12 publications

(23 reference statements)

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“…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].…”

Section: Discussionmentioning

confidence: 99%

“…Among metastatic tumors involving the leptomeninges, adenocarcinomas (mostly lung, breast or gastrointestinal primary), hematopoietic malignancies and disseminated melanoma are the most commonly shed cells [1,2,3]. The diagnosis of metastatic adenocarcinoma in CSF is relatively less challenging in comparison to a definitive diagnosis of metastatic squamous cell carcinoma.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2012

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Background: Squamous cell carcinoma metastatic to cerebrospinal fluid (CSF) is a rare diagnosis on cytology, and thereby more challenging in comparison to an adenocarcinoma metastatic to CSF. We recently encountered a case of metastatic squamous cell carcinoma in CSF. The primary site was unknown. A review of the literature was performed to understand why this is a rare diagnosis in cytology. Case: A 56-year-old male was diagnosed with a keratinizing squamous cell carcinoma involving multiple lymph nodes in the neck. On extensive clinical and radiologic evaluation, a primary could not be identified. Subsequently, the patient presented with sudden loss of vision (in the right eye), nausea and vomiting. MRIs of the lumbar spine and optic nerve were suggestive of leptomeningeal and perineural seeding, respectively. Cytologic evaluation of CSF revealed a few atypical, round hyperchromatic cells which were confirmed as epithelial cells through immunocytochemistry for a broad-spectrum keratin. The diagnosis of metastatic carcinoma consistent with squamous cell carcinoma was rendered. Conclusion: Definitive diagnosis of metastatic squamous cell carcinoma is challenging unless clinical evidence is present. Besides other factors, the mode of spread to CSF may be responsible for this less common diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2012

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“…Sioutopoulou et al [17] evaluated the application of TP LBC in the diagnosis of metastatic tumors in CSF samples. TP technology provided the preservation of the following features:…”

Section: Fluidsmentioning

confidence: 99%

Overview of Nongynecological Samples Prepared with Liquid-Based Cytology Medium

Ren

Solomides²,

Draganova‐Tacheva³

et al. 2014

Acta Cytologica

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Objective: Liquid-based cytology of nongynecological specimens is commonly used in cytology laboratories throughout the world and various processing methods, such as ThinPrep and SurePath, have been reported. The cytological features and performance of liquid-based cytology for various cytology specimens, including body cavity fluids, urine, brushing specimens and fine-needle aspiration of various lesions, were reviewed and compared with the experience of our laboratory and the literature published in PubMed. Study Design: The parameters for the evaluation of liquid-based cytology and conventional smears were described in the various types of specimens. Criteria for the interpretation of nongynecological liquid-based cytology were highlighted to show differences in cell morphology, background and artifacts. Results: The interpretation requires familiarity with the appearance of liquid-based cytology in the various types of preparations to avoid misdiagnosis. Conclusions: Cell blocks can be prepared with specimens preserved in a liquid-based cytology medium and immunocytochemical stains and molecular testing can be successfully performed. These are important adjuncts in order to reach a definitive diagnosis.

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“…Thus, IC can be one of the best helping agents for the pathologist, in the differentiation of inflammation and hematological malignancies and in determining the primary origin of the metastatic tumor cells. Several studies have reported on the success of IC use in LBC [10,11,12]. According to these studies, the immunostaining in LBC shows equal or greater efficiency than centrifugation and cytocentrifugation and can replace or complement these preparations.…”

Section: Discussionmentioning

confidence: 99%

“…There seem to only be a few articles about IC use in CSF materials prepared with LBC. Sioutopoulou et al [10] used 17 immunocytochemical markers in CSF samples using thin-layer cytology in their study and they detected the origin of neoplastic cells in all of the tumors of unknown primary site. Therefore, they believed that thin-layer cytology was the most appropriate technique for cytological diagnosis of CSF.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of the Liquid-Based Preparation Method in Cerebrospinal Fluid Cytology

Argon

Uyaroğlu²,

Nart³

et al. 2013

Acta Cytologica

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Objectives: Since malignant cells were first detected in the cerebrospinal fluid (CSF), numerous methods have been used for CSF examination. The cytocentrifugation and liquid-based cytology (LBC) methods are two of these. We aimed to investigate whether the results from the LBC method were different from the results of the cytological diagnosis of the CSF materials that were prepared using the cytocentrifugation method. Materials and Methods: A retrospective analysis was conducted using the pathological records of 3,491 (cytocentrifugation on 1,306 and LBC on 2,185) cytological specimens of CSF which were diagnosed over a 4-year period between January 2007 and December 2011. The Fisher exact test was used to compare the results of the LBC and cytocentrifugation methods. Results: While there was a noticeable decrease in nondiagnostic diagnosis and a slight decrease in suspicious diagnosis, there was an increase in malignant and benign diagnosis with the LBC method in comparison to the centrifugation method. Statistically, the decrease in nondiagnostic diagnosis was considered significant (p < 0.0001). Discussion: The LBC method seems like a better option than the cytocentrifugation method, because of many preparatory, screening and diagnostic advantages, especially in pathology departments where materials come from far away and large volumes are examined.

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

Cited by 17 publications

References 12 publications

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

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

Overview of Nongynecological Samples Prepared with Liquid-Based Cytology Medium

The Effectiveness of the Liquid-Based Preparation Method in Cerebrospinal Fluid Cytology

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