title: Cytology of primary central nervous system neoplasms in cerebrospinal fluid specimens.
abstract: 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.
authors.affiliation: Department of Pathology, University of Alabama at Birmingham, Alabama. dchhieng@path.uab.edu
authors.forename: David C
authors.initials: DC
authors.lastname: Chhieng
authors.forename: Paul
authors.initials: P
authors.lastname: Elgert
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Cohen
authors.forename: Nirag C
authors.initials: NC
authors.lastname: Jhala
authors.forename: Joan F
authors.initials: JF
authors.lastname: Cangiarella
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001254:Astrocytoma / Q000134:cerebrospinal fluid / Q000378:metabolism / Q000473:pathology; D014408:Biomarkers, Tumor / Q000378:metabolism; D016543:Central Nervous System Neoplasms / Q000134:cerebrospinal fluid* / Q000378:metabolism / Q000473:pathology*; D002555:Cerebrospinal Fluid / Q000166:cytology*; D002648:Child; D003937:Diagnosis, Differential; D004806:Ependymoma / Q000134:cerebrospinal fluid / Q000378:metabolism / Q000473:pathology; D005260:Female; D018237:Germinoma / Q000134:cerebrospinal fluid / Q000378:metabolism / Q000473:pathology*; D005910:Glioma / Q000134:cerebrospinal fluid* / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008223:Lymphoma / Q000134:cerebrospinal fluid / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008527:Medulloblastoma / Q000134:cerebrospinal fluid / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged
chemical_list: D014408:Biomarkers, Tumor