Primary leptomeningeal melanoma. Diagnosis by ultrastructural cytology of cerebrospinal fluid and cranial computed tomography.
A case of primary leptomeningeal melanoma is presented in which the diagnosis was made by ultrastructural demonstration of melanoma cells from the cerebrospinal fluid (CSF) at a time when cranial computed tomography (CT) still gave negative results. Later CT examinations documented the emergence of a tumor mass of the left temporoparietal lobe. This case clearly illustrates the complementary role of these investigational procedures for the diagnosis of cerebrospinal melanoma: leptomeningeal involvement, characterized by two-dimensional diffuse spread of melanoma tissue ("leptomeningeal melanomatosis"), is invisible with CT, but easily recognisable by CSF cytology; in contrast, nodular parenchymal tumor deposits can be readily detected by CT. Identification of pigmented cells recovered from the CSF requires ultrastructural confirmation.
D001921:Brain / Q000000981:diagnostic imaging*; D003287:Contrast Media; D006801:Humans; D008297:Male; D008545:Melanoma / Q000134:cerebrospinal fluid* / Q000000981:diagnostic imaging / Q000648:ultrastructure; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid* / Q000000981:diagnostic imaging / Q000648:ultrastructure; D008854:Microscopy, Electron; D008875:Middle Aged; D010296:Parietal Lobe; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D003287:Contrast Media