Intraoperative Cytodiagnosis of Metastatic Brain Tumors Confused Clinically with Brain Abscess

Monabati, Ahmad; Kumar, Perikala V.; Kamkarpour, Ahmad

doi:10.1159/000328494

Cited by 21 publications

(12 citation statements)

References 11 publications

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“…A combination of surgical intervention and antifungal agents may provide a better outcome as had been suggested for other cerebral phaeohyphomycosis. 19 Utilization of aspirated material from fungal brain abscess to reach a diagnosis had been limited to sporadic cases. In one study, the cytologic diagnosis of 66 cases was compared with a histologic diagnosis and it was found that the cytologic diagnosis agreed with the histologic diagnosis in 92% of cases of intracranial lesions.…”

Section: Discussionmentioning

confidence: 99%

Aspiration cytology of brain abscess from a fatal case of cerebral phaeohyphomycosis due to Ramichloridium mackenziei

M.D.

Al‐Tawfiq

2007

Diagnostic Cytopathology

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Ramichloridium mackenziei is a dematiaceous fungus that usually causes cerebral phaeohyphomycosis. We describe the aspiration cytology findings of a case of cerebral abscess caused by R. mackenziei in a 66-yr-old Saudi woman who had a long standing history of diabetes mellitus and a recent diagnosis of systemic lupus erythematosus. She was on long-term corticosteroid therapy. The patient developed rapidly progressive multiple brain abscesses and died despite aspiration of the abscess and administration of intravenous amphotericin B lipid complex and voriconazole.

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Section: Discussionmentioning

confidence: 99%

Aspiration cytology of brain abscess from a fatal case of cerebral phaeohyphomycosis due to Ramichloridium mackenziei

M.D.

Al‐Tawfiq

2007

Diagnostic Cytopathology

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“…Monabati 14 reported three cases of cystic brain lesions clinically suspected to be abscesses. Frozen sections proved nondiagnostic in all three cases.…”

Section: Discussionmentioning

confidence: 99%

Cytological diagnosis of cystic brain tumors: A retrospective study of 88 cases

Hernández

Zagzag

Kelly

et al. 2004

Diagnostic Cytopathology

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The stereotaxic aspiration of cystic brain tumors is performed to provide cyst decompression and/or to facilitate surgical resection. The purpose of our study was to determine the diagnostic value of brain cyst fluid cytology, especially in clinically suspected recurrent tumors with no histological follow-up (HF), when a diagnosis is most needed. We reviewed the cytological diagnoses of 88 aspirates from 70 patients with cystic brain tumors between 1995 and 2001, of which 31 had a prior known malignancy including 18 primary brain tumors (PBTs) and 13 adenocarcinomas (ACAs). Sixty-nine of 88 aspirates were obtained intraoperatively. Nineteen of 88 aspirates were obtained from 10 patients with recurrent or persistent cystic brain tumors (8 patients with PBT and 2 patients with ACA), with available clinicoradiological correlation (magnetic resonance imaging/computed tomography [MRI/CT] scans) in 13 of them. The 88 aspirates were classified in three categories: 28 positive (32%), 15 atypical (17%), and 45 negative (51%). Eight of 28 positive cases (5 case of PBT, 2 cases of ACA, and 1 case of melanoma) were given a nonspecific diagnosis of malignant neoplasm (9% of all cases). Fifteen of 28 positive cases (6 cases of PBT, 8 cases of ACA, and 1 case of melanoma) were diagnosed correctly and confirmed by HF (17% of all cases). Four of 28 cases were ACA diagnosed solely by cytology (<4% of all cases). One neurocytoma (1/28) case was mistaken for an oligodendroglioma despite cell blocks (CBs) and immunophenotyping (IPT) (<1% of all cases). Eleven of 15 atypical cases were 8 cases of PBT, 2 cases of ACA, and 1 case of postoperative change (PC). Four of 15 atypical cases (from three patients with suspected PBT recurrence) could not be further characterized by CB/IPT and had no HF. Twenty-seven of 45 negative cases were falsely negative (23 cases of PBT, 3 cases of ACA, and 1 case of malignant neoplasm); 11/45 cases were PC, and 7/45 (from five patients with clinically suspected tumor recurrence) cases had no HF. Cytological evaluation of brain cyst fluid is not a reliable means of diagnosing cystic brain neoplasms (including recurrences) due to a high false negative rate and a low sensitivity. Most of the negative or atypical cases (68% of all cases) were recurrent PBT of glial origin that may not be prone to exfoliate. These cytological specimens consisted of lysed blood, obscuring inflammatory cells, and degenerated diagnostic cells if any, yielding inconclusive results.

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“…Cystic lesions in metastatic brain tumors can be misdiagnosed as brain abscesses, primary cerebral tumors or parasitic infections, especially in patients without a history of malignancies [3][4][5][6]. There have been only few case reports showing cystic brain metastases and this type of metastasis has been described in carcinomas of the thymus, breast, prostate and pancreas [5,[8][9][10]. The location of brain masses is also one of the important features to make a diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, the cases showing unusual location and radiologic findings, especially in a patient with no previous cancer history, have diagnostic difficulties. Moreover, when the metastasis presents with cystic lesions in MRI, several diseases, such as true cysts, abscess formation, cysticercosis, fungal infections and cerebral tumors should be considered [2][3][4][5][6]. Although cysticercosis, the infection of the human brain by the larvae of Taenia solium, is rare in Europe, it is still a common cause of headache and epilepsy in Asia and should be suspected in cases showing multiple cystic lesions on brain MRI.…”

Section: Introductionmentioning

confidence: 99%

Multiple Cystic Brain Metastases from Adenocarcinoma Mimicking Cysticercosis

Choi

2011

Clin Neuroradiol

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Intraoperative Cytodiagnosis of Metastatic Brain Tumors Confused Clinically with Brain Abscess

Cited by 21 publications

References 11 publications

Aspiration cytology of brain abscess from a fatal case of cerebral phaeohyphomycosis due to Ramichloridium mackenziei

Aspiration cytology of brain abscess from a fatal case of cerebral phaeohyphomycosis due to Ramichloridium mackenziei

Cytological diagnosis of cystic brain tumors: A retrospective study of 88 cases

Multiple Cystic Brain Metastases from Adenocarcinoma Mimicking Cysticercosis

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