title: Young investigator challenge: Cytomorphologic analysis of cerebrospinal fluid in 70 pediatric patients with medulloblastoma and review of the literature focusing on novel diagnostic and prognostic tests.
abstract: BACKGROUND
  Medulloblastoma (MB) is the most common malignant pediatric brain tumor and is currently treated with combined therapies. Recent advances in genetics and protein expression in this entity have led to the elaboration of a new molecular classification, and novel targeted therapies are currently under trial. This objective of this study was to describe the cytomorphologic features of MB in cerebrospinal fluid (CSF).
  
  
  METHODS
  The authors conducted a retrospective study of 194 CSF samples from 70 pediatric patients who had a history of primary MB. The samples consisted of CSF cytospins that were stained according to the May-Grunwald Giemsa and/or Papanicolaou methods.
  
  
  RESULTS
  In 32 patients, it was possible to establish a confident diagnosis of metastatic MB. Common morphologic features included cell clustering, nuclear irregularity, molding and enlargement, and prominent nucleoli. Multinucleation as well as mitotic and apoptotic figures were less frequently observed. Fifteen samples that presented neither cell clustering nor nuclear molding were classified as suspicious.
  
  
  CONCLUSIONS
  Cell clustering with nuclear molding is a key feature for the diagnosis of leptomeningeal metastasis of MB.
authors.affiliation: Department of Biopathology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France.
authors.forename: Domenico
authors.initials: D
authors.lastname: Damiani
authors.affiliation: Department of Biopathology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France.
authors.forename: Voichita
authors.initials: V
authors.lastname: Suciu
authors.affiliation: Department of Biopathology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France.
authors.forename: Felipe
authors.initials: F
authors.lastname: Andreiuolo
authors.affiliation: Department of Biopathology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Calderaro
authors.affiliation: Department of Biopathology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Vielh
mesh_terms: D000293:Adolescent; D002528:Cerebellar Neoplasms / Q000134:cerebrospinal fluid / Q000473:pathology*; D002555:Cerebrospinal Fluid / Q000166:cytology*; D002648:Child; D002675:Child, Preschool; D003581:Cytodiagnosis / Q000379:methods; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008527:Medulloblastoma / Q000134:cerebrospinal fluid / Q000473:pathology*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012108:Research Personnel; D012189:Retrospective Studies; D012494:Sampling Studies; D012680:Sensitivity and Specificity
keywords: cerebrospinal fluid; childhood; cytology; medulloblastoma; metastasis