title: [Leptomeningeal gliomatosis with high levels of adenosine deaminase in the cerebrospinal fluid].
abstract: A 61-year-old man developed disturbance of consciousness for 2 weeks. He showed neck stiffness and hyporeflexia. Analysis of his cerebrospinal fluid (CSF) revealed pleocytosis and markedly reduced glucose contents. Adenosine deaminase (ADA) levels in the CSF were elevated (28.8 IU/l). Brain magnetic resonance imagings showed enhancement of the leptomeninges. Tuberculous meningitis was considered, but antituberculous drug was not effective. Repeated cytological analysis of the CSF demonstrated atypical cells with enlarged unevenly distributed nuclei and immunoreactive with glial fibrillary acidic protein. We diagnosed him as leptomeningeal gliomatosis. CSF ADA may be elevated in this rare disorder, and here we emphasize that repeated cytological analysis with immunohistochemical staining was useful for diagnosis.
authors.affiliation: Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nishihara
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Omoto
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Ogasawara
authors.forename: Michiaki
authors.initials: M
authors.lastname: Koga
authors.forename: Motoharu
authors.initials: M
authors.lastname: Kawai
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanda
mesh_terms: D000243:Adenosine Deaminase / Q000134:cerebrospinal fluid*; D014408:Biomarkers, Tumor / Q000134:cerebrospinal fluid*; D002555:Cerebrospinal Fluid / Q000166:cytology; D003584:Cytological Techniques; D003937:Diagnosis, Differential; D005904:Glial Fibrillary Acidic Protein / Q000134:cerebrospinal fluid; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D018302:Neoplasms, Neuroepithelial / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D005904:Glial Fibrillary Acidic Protein; D000243:Adenosine Deaminase