The role of monoclonal antibodies in brain tumour diagnosis and cerebrospinal fluid (CSF) cytology

Garson, Jeremy A.; Coakham, H. B.; Kemshead, J. T.; Brownell, Betty; Harper, Ei; Allan, Patricia; Bourne, S. P.

doi:10.1007/bf02228893

Cited by 38 publications

(16 citation statements)

References 22 publications

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“…In our experience as well as that of others, the selective use of immunocytochemistry is useful in detecting malignant cells. 17,18 For example, in the current study, we used PLAP and neuroendocrine markers to highlight the neoplastic cells of germinoma and ganglioneurocytoma, respectively. Glial fibrillary acidic protein (GFAP) recognizes cells of astrocytic origin.…”

Section: Discussionmentioning

confidence: 99%

Cytology of primary central nervous system neoplasms in cerebrospinal fluid specimens

Chhieng

Elgert

Cohen

et al. 2002

Diagnostic Cytopathology

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Although two-thirds of tumors occurring in the central nervous system (CNS) are primary neoplasms, only 10% of positive cerebrospinal fluid (CSF) specimens are from primary CNS tumors. In this study, we reviewed the cytologic findings of 21 positive CSF specimens from primary CNS tumors. A computer search identified 21 cases of positive CSF specimens from patients with primary CNS tumors from the archives. Follow-up included review of medical charts and histologic correlation. The specimens were from 20 patients (9 females and 11 males). Their ages ranged from 6-83 yr, old with a mean of 30 yr. The cases included 9 medulloblastomas, 7 gliomas (3 glioblastoma multiformes, 2 anaplastic astrocytomas, and 2 ependymomas), 2 germinomas, 2 non-Hodgkin's large B-cell lymphomas, and 1 ganglioneurocytoma. Two cases were classified as suspicious and the remaining as positive for malignancy. Immunocytochemistry was employed in 3 cases to support the cytologic diagnosis. These cases included one large-cell lymphoma (leukocyte-common antigen-positive), one germinoma (placental alkaline phosphatase-positive), and the ganglioneurocytoma (neuron-specific enolase- and synaptophysin-positive). There were no false-positive cases. Our results suggest that positive CSF cytology in patients with a primary CNS tumor is a reliable indicator of malignancy and reflects leptomeningeal involvement. The use of immunocytochemistry is helpful in confirming the cytologic impression in some cases.

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Section: Discussionmentioning

confidence: 99%

Cytology of primary central nervous system neoplasms in cerebrospinal fluid specimens

Chhieng

Elgert

Cohen

et al. 2002

Diagnostic Cytopathology

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“…Use of monoclonal antibodies for immunohistochemical analysis in solid tumor leptomeningeal metastases does not significantly increase the sensitivity of cytology alone [34][35][36]. However, in the case of leukemia and lymphoma, antibodies against surface markers can be used to distinguish between reactive and neoplastic lymphocytes in the CSF [37].…”

Section: Cerebrospinal Fluid Examinationmentioning

confidence: 99%

Neoplastic meningitis

Aparicio

Chamberlain

2002

Curr Neurol Neurosci Rep

115

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Neoplastic meningitis (NM) is a common problem in neuro-oncology, occurring in approximately 5% of all patients with cancer. Notwithstanding frequent focal signs and symptoms, NM is a disease that affects the entire neuraxis; therefore, staging and treatment need to encompass all cerebrospinal fluid (CSF) compartments. Central nervous system (CNS) staging of NM includes contrast-enhanced cranial computerized tomography or magnetic resonance imaging, contrast-enhanced spine magnetic resonance imaging or computerized tomographic myelography, and radionuclide CSF flow study. Treatment of NM involves involved-field radiotherapy of bulky or symptomatic disease sites and intra-CSF drug therapy. The inclusion of concomitant systemic therapy may benefit patients with NM and may obviate the need for intra-CSF chemotherapy. At present, intra-CSF drug therapy is confined to three chemotherapeutic agents (ie, methotrexate, cytosine arabinoside, and thio-triethylene thiophosphoramide) administered by a variety of schedules either by intralumbar or intraventricular drug delivery. Although treatment of NM is palliative with an expected median patient survival of 2 to 6 months, it often affords stabilization and protection from further neurologic deterioration in patients with NM.

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“…32 Use of monoclonal antibodies for immunohistochemical analysis in NM does not significantly increase the sensitivity of cytology alone. [33][34][35] However, in the case of leukemia and lymphoma, antibodies against surface markers can be used to distinguish between reactive and neoplastic lymphocytes in the CSF. 36 Cytogenetic studies have also been evaluated in an attempt to improve the diagnostic accuracy of NM.…”

Section: Chamberlainmentioning

confidence: 99%