Cytologic diagnosis of a metastatic oligodendroglioma in a pleural effusion. A case report.
BACKGROUND
Extraneural metastasis of oligodendroglioma is extremely rare and is diagnosed primarily by biopsy or autopsy and very occasionally by fine needle cytologic examination. We report a case of metastatic oligodendroglioma diagnosed by cytologic examination of a pleural effusion. Such a diagnosis has not been reported before.


METHODS
A 64-year-old woman developed anemia and bilateral pleural effusion 7 years after an operation for an oligodendroglioma over the left frontal lobe. Cytologic examination of the pleural effusion showed aggregates of atypical polygonal cells containing round, hyperchromatic nuclei and scanty, granular cytoplasm in Liu's and Papanicolaou stain and cell blocks. Immunohistochemical staining of the tumor cells revealed a positive reaction for antibodies to glial fibrillary acidic protein, S-100 and Olig2. Pleural biopsy confirmed the cytologic diagnosis of pleural effusion. A pathologic fracture of the right humeral and femoral bones was noted 1 month later, and the specimen also showed infiltrating oligodendroglioma cells in bone tissue.


CONCLUSIONS
To the best of our knowledge, this is the first metastatic oligodendroglioma diagnosed by pleural cytology. Fine needle cytology can provide a reliable and rapid way to detect an extracranial metastatic oligodendroglioma in different organs.
Lee
Chin-Cheng
CC
Department of Pathology and Laboratory Medicine, Chest Medicine, Orthopedics and Neurosurgery, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Jiang
Jiunn-Song
JS
Chen
Eric Tsu-shin
ET
Yokoo
Hideaki
H
Pan
Yu-Hua
YH
Tsai
Ming-Dar
MD
D051792:Basic Helix-Loop-Helix Proteins / Q000032:analysis / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000032:analysis / Q000378:metabolism; D044963:Biopsy, Fine-Needle; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000556:secondary; D001842:Bone and Bones / Q000473:pathology / Q000503:physiopathology; D001932:Brain Neoplasms / Q000473:pathology*; D002467:Cell Nucleus / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D005904:Glial Fibrillary Acidic Protein / Q000032:analysis / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000032:analysis / Q000378:metabolism; D000076104:Oligodendrocyte Transcription Factor 2; D009837:Oligodendroglioma / Q000175:diagnosis* / Q000556:secondary; D065006:Papanicolaou Test; D010994:Pleura / Q000473:pathology / Q000503:physiopathology; D016066:Pleural Effusion, Malignant / Q000175:diagnosis* / Q000209:etiology; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000556:secondary; D011237:Predictive Value of Tests; D011379:Prognosis; D009418:S100 Proteins / Q000032:analysis / Q000378:metabolism; D014626:Vaginal Smears
D051792:Basic Helix-Loop-Helix Proteins; D014408:Biomarkers, Tumor; D005904:Glial Fibrillary Acidic Protein; D009419:Nerve Tissue Proteins; D000076104:Oligodendrocyte Transcription Factor 2; D009418:S100 Proteins; C405708:OLIG2 protein, human