The application of immunocytochemistry in diagnosis of meningeal carcinomatosis in a patient with unknown primary site.
A 55-year-old female with meningeal signs was suspected to have carcinomatosis meningitis based on cytospin cytology study of cerebrospinal fluid (CSF) with Wright stain. There was no primary site of any malignancy which could be identified as the source of metastasis. Immunochemical staining for cytokeratin and carcinoembryonic antigen on suspicious large immature cells in the CSF gave positive results and confirmed the malignant nature of her disease. Intrathecal chemotherapy with methotrexate and whole brain irradiation then eradicated the symptoms rapidly. Immunocytochemistry was considered to be a very powerful diagnostic tool in management of this patient.
Lee
C T
CT
Department of Medicine, Veterans General Hospital-Taipei, R.O.C.
Fan
F S
FS
Chen
P M
PM
Liu
H C
HC
D000230:Adenocarcinoma / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D002272:Carcinoembryonic Antigen / Q000134:cerebrospinal fluid; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000134:cerebrospinal fluid; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000134:cerebrospinal fluid / Q000175:diagnosis*
D002272:Carcinoembryonic Antigen; D007633:Keratins