Diagnóstico citopatológico de tumores neuroepiteliais pela técnica do esfregaço

Torres, Luiz F. Bleggi; Collaço, Luiz Martins

doi:10.1590/S0004-282X1992000200007

Resumos

Estudamos grupo de 198 casos de tumores neuroepiteliais com diagnóstico peroperatório feito pela análise citológica de esfregaços, comparando seus índices de acuidade com o diagnóstico final em cortes de parafina. Em 90,6% dos casos, o diagnóstico final obtido na parafina foi similar ao feito em esfregaços. No grupo de casos em que o diagnóstico citológico não foi confirmado pelos cortes em parafina, na maioria dos casos não foi afetada a conduta neurocirúrgica imediata, representando diferenças em graduação de astrocitomas e gliomas mistos. Os critérios citológicos nos principais grupos de tumores são apresentados, junto com as dificuldades para a interpretação deste método valioso para diagnóstico per-operatório.

tumores neuroepiteliais; diagnóstico citopatológico per-operatório; técnica do esfregaço

We studied 198 cases of neuroepithelial tumours with, intra-operative diagnosis made by smears comparing the accuracy rates with the final paraffin section diagnosis. In 90,6% of cases the final diagnosis obtained on paraffin preparations was similar to that made on smears. In the group of oases with cytclogical diagnosis not confirmed by paraffin sections the majority of cases were unlike to affect immediate neurosurgical management, and represent mainly differences in grading of astrocytomas and mixed gliomas. The cytological diagnostic criteria are discussed together with the main difficulties for the interpretation of this valuable approach to intra-operative neurosurgical diagnosis.

neuroepithelial tumours; intra-operative cytopathologic diagnosis; smear technique

Luiz F. Bleggi Torres^I; Luiz Martins Collaço^II

^IProfessor Adjunto, Ph.D. em Neuropatologia. Trabalho realizado nas Unidades de Neuropatologia e Citologia dos Serviços de. Anatomia Patológica do Hospital Nossa Senhora das Graças e Hospital de Clínicas da Universidade Federal do Paraná (UFPR)

^IIProfessor Auxiliar. Trabalho realizado nas Unidades de Neuropatologia e Citologia dos Serviços de. Anatomia Patológica do Hospital Nossa Senhora das Graças e Hospital de Clínicas da Universidade Federal do Paraná (UFPR)

RESUMO

Estudamos grupo de 198 casos de tumores neuroepiteliais com diagnóstico peroperatório feito pela análise citológica de esfregaços, comparando seus índices de acuidade com o diagnóstico final em cortes de parafina. Em 90,6% dos casos, o diagnóstico final obtido na parafina foi similar ao feito em esfregaços. No grupo de casos em que o diagnóstico citológico não foi confirmado pelos cortes em parafina, na maioria dos casos não foi afetada a conduta neurocirúrgica imediata, representando diferenças em graduação de astrocitomas e gliomas mistos. Os critérios citológicos nos principais grupos de tumores são apresentados, junto com as dificuldades para a interpretação deste método valioso para diagnóstico per-operatório.

Palavras-chave: tumores neuroepiteliais, diagnóstico citopatológico per-operatório, técnica do esfregaço.

SUMMARY

We studied 198 cases of neuroepithelial tumours with, intra-operative diagnosis made by smears comparing the accuracy rates with the final paraffin section diagnosis. In 90,6% of cases the final diagnosis obtained on paraffin preparations was similar to that made on smears. In the group of oases with cytclogical diagnosis not confirmed by paraffin sections the majority of cases were unlike to affect immediate neurosurgical management, and represent mainly differences in grading of astrocytomas and mixed gliomas. The cytological diagnostic criteria are discussed together with the main difficulties for the interpretation of this valuable approach to intra-operative neurosurgical diagnosis.

Key words: neuroepithelial tumours, intra-operative cytopathologic diagnosis, smear technique.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Agradecimentos - Os autores agradecem os demais patologistas e neurocirurgiões de ambos os hospitais, pelo auxílio na coleta dos casos, bem como os técnicos e citotécnicos, pela confecção do material.

REFERÊNCIAS

1. Bancroft J, Stevens A. Theory and Practice of Histological Techniques. Edinbourgh: Churchill Livingstone, 1982, p 332-363.

2. Bekerley BB, Adams JH, Doyle D, Graham DI, Harper CG. The smear technique in the diagnosis of neurosurgical biopsies. NZ Med J 1978, 87:12-15.

3. Bibbo M. Comprehensive Cytopathology. Philadelphia: W.B. Saunders, 1991.

4. Burger PC. Use of cytological preparations in the frozen section diagnosis of central nervous system neoplasia. Am J Surg Pathol 1985, 9:344-354.

5. Cahill EM, Hidvegi DF. Crush preparations of lesions of the central nervous system: a useful adjunct to the frozen section. Acta Cytol 1985, 29:279-285.

6. Gray F, Gherardi R, Scaravilli F. The neuropathology of the acquired immune deficiency syndrome (AIDS): a review. Brain 1988, 111:245-266.

7. Hume Adams J, Granan DI, Doyle D. Brain Biopsy: The Smear Technique for Neurosurgical Biopsies. London: Chapman and Hall, 1981, p 2-124.

8. Kawano N, Yade K, Aihara M, Yashigita S. Oligodendroglioma-like. cells (clear cells) in ependymoma. Acta Neuropath (Berlin) 1983, 62:141-145.

9. Kepes J J. Review of the WHO's new proposed classification of brain tumors. Annals

of the Xlth International Congress of Neuropathology, Kyoto, 1990, p 6. 10. Marshall LF, Adams JH, Doyle D, Graham DI. The histological biopsies. J Neurosurg 1973, 39:82-88.

11. Mouriquand C, Benabid AL, Breyton M. Stereotaxic cytology of brain tumours: review of an eight-year experience. Acta Cytol 1986, 31:756-764.

12. Navia BA, Petito CK, Gold JWM, Cho E-S, Jordan BD, Price RW. Cerebral toxoplasmosis complicating the acquired immune deficiency syndrome: clinical and neuropathological findings in 27 patients. Ann Neurol 1986, 19:224-238.

13. Ostertag CB, Mennel HD, Kiesling M. Stereotactic biopsy of brain tumours. Surg Neurol 1980, 14:275-283.

14. Russell DS, Rubinstein L.J. Pathology of Tumours of the Nervous System. Ed5. London: Edward Arnold, 1989.

15. Taratuto AL, Sevlever G, Piccardo P. Clues and pitfalls in stereotaxic biopsy of the central nervous system. Arch Pathol Lab Med 1991, 115:596-602.

16. Torres LFB. Citopatologia do sistema nervoso: critérios diagnósticos para análise de esfregaços de tumores do sistema nervoso. XIII Congresso Brasileiro de Citopatologia, 1991.

17. Torres LFB, Almeida R, Avila S, Alessi S, Freitas R. Brains tumours in South Brazil: a retrospective study of 438 cases. Arq Neuro-Psiquiat (São Paulo) 1990, 48:279-285.

18. Torres LFB, Collaço LM. Análise citológica per-operatória de lesões do sistema nervoso central e periférico. Anais do XVIII Congresso Latino Americano de Patologia 1991, 1:101 (Abst).

19. World Health Organization. Histological Typing of Tumors of the Central Nervous System. Geneva: WHO, 1991.

20. Zhang YX, Luo KS, Liv JC, Chen Y, Chen YH, Lai RS. Cytological diagnosis of 500 cases of intracranial tumors during craniotomy. Chinese J Clin Cytol 1987, 3:19-27.

Dr. Luiz Fernando Bleggi Torres Centro de Patologia de Curitiba - Rua Alcides Munhoz 433 - 80510 Curitiba PR - Brasil.

1. Bancroft J, Stevens A. Theory and Practice of Histological Techniques. Edinbourgh: Churchill Livingstone, 1982, p 332-363.
2. Bekerley BB, Adams JH, Doyle D, Graham DI, Harper CG. The smear technique in the diagnosis of neurosurgical biopsies. NZ Med J 1978, 87:12-15.
3. Bibbo M. Comprehensive Cytopathology. Philadelphia: W.B. Saunders, 1991.
4. Burger PC. Use of cytological preparations in the frozen section diagnosis of central nervous system neoplasia. Am J Surg Pathol 1985, 9:344-354.
5. Cahill EM, Hidvegi DF. Crush preparations of lesions of the central nervous system: a useful adjunct to the frozen section. Acta Cytol 1985, 29:279-285.
6. Gray F, Gherardi R, Scaravilli F. The neuropathology of the acquired immune deficiency syndrome (AIDS): a review. Brain 1988, 111:245-266.
7. Hume Adams J, Granan DI, Doyle D. Brain Biopsy: The Smear Technique for Neurosurgical Biopsies. London: Chapman and Hall, 1981, p 2-124.
8. Kawano N, Yade K, Aihara M, Yashigita S. Oligodendroglioma-like. cells (clear cells) in ependymoma. Acta Neuropath (Berlin) 1983, 62:141-145.
of the Xlth International Congress of Neuropathology, Kyoto, 1990, p 6. 10. Marshall LF, Adams JH, Doyle D, Graham DI. The histological biopsies. J Neurosurg 1973, 39:82-88.
11. Mouriquand C, Benabid AL, Breyton M. Stereotaxic cytology of brain tumours: review of an eight-year experience. Acta Cytol 1986, 31:756-764.
12. Navia BA, Petito CK, Gold JWM, Cho E-S, Jordan BD, Price RW. Cerebral toxoplasmosis complicating the acquired immune deficiency syndrome: clinical and neuropathological findings in 27 patients. Ann Neurol 1986, 19:224-238.
13. Ostertag CB, Mennel HD, Kiesling M. Stereotactic biopsy of brain tumours. Surg Neurol 1980, 14:275-283.
14. Russell DS, Rubinstein L.J. Pathology of Tumours of the Nervous System. Ed5. London: Edward Arnold, 1989.
15. Taratuto AL, Sevlever G, Piccardo P. Clues and pitfalls in stereotaxic biopsy of the central nervous system. Arch Pathol Lab Med 1991, 115:596-602.
16. Torres LFB. Citopatologia do sistema nervoso: critérios diagnósticos para análise de esfregaços de tumores do sistema nervoso. XIII Congresso Brasileiro de Citopatologia, 1991.
17. Torres LFB, Almeida R, Avila S, Alessi S, Freitas R. Brains tumours in South Brazil: a retrospective study of 438 cases. Arq Neuro-Psiquiat (São Paulo) 1990, 48:279-285.
18. Torres LFB, Collaço LM. Análise citológica per-operatória de lesões do sistema nervoso central e periférico. Anais do XVIII Congresso Latino Americano de Patologia 1991, 1:101 (Abst).
19. World Health Organization. Histological Typing of Tumors of the Central Nervous System. Geneva: WHO, 1991.
20. Zhang YX, Luo KS, Liv JC, Chen Y, Chen YH, Lai RS. Cytological diagnosis of 500 cases of intracranial tumors during craniotomy. Chinese J Clin Cytol 1987, 3:19-27.

Diagnóstico citopatológico de tumores neuroepiteliais pela técnica do esfregaço

Cytopathologie diagnosis of neuroepithelial tumours by the smear technique

Datas de Publicação

Publicação nesta coleção
22 Fev 2011
Data do Fascículo
Jun 1992

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Bancroft J, Stevens A. Theory and Practice of Histological Techniques. Edinbourgh: Churchill Livingstone, 1982, p 332-363.

[2] 2. Bekerley BB, Adams JH, Doyle D, Graham DI, Harper CG. The smear technique in the diagnosis of neurosurgical biopsies. NZ Med J 1978, 87:12-15.

[3] 3. Bibbo M. Comprehensive Cytopathology. Philadelphia: W.B. Saunders, 1991.

[4] 4. Burger PC. Use of cytological preparations in the frozen section diagnosis of central nervous system neoplasia. Am J Surg Pathol 1985, 9:344-354.

[5] 5. Cahill EM, Hidvegi DF. Crush preparations of lesions of the central nervous system: a useful adjunct to the frozen section. Acta Cytol 1985, 29:279-285.

[6] 6. Gray F, Gherardi R, Scaravilli F. The neuropathology of the acquired immune deficiency syndrome (AIDS): a review. Brain 1988, 111:245-266.

[7] 7. Hume Adams J, Granan DI, Doyle D. Brain Biopsy: The Smear Technique for Neurosurgical Biopsies. London: Chapman and Hall, 1981, p 2-124.

[8] 8. Kawano N, Yade K, Aihara M, Yashigita S. Oligodendroglioma-like. cells (clear cells) in ependymoma. Acta Neuropath (Berlin) 1983, 62:141-145.

[10] of the Xlth International Congress of Neuropathology, Kyoto, 1990, p 6. 10. Marshall LF, Adams JH, Doyle D, Graham DI. The histological biopsies. J Neurosurg 1973, 39:82-88.

[11] 11. Mouriquand C, Benabid AL, Breyton M. Stereotaxic cytology of brain tumours: review of an eight-year experience. Acta Cytol 1986, 31:756-764.

[12] 12. Navia BA, Petito CK, Gold JWM, Cho E-S, Jordan BD, Price RW. Cerebral toxoplasmosis complicating the acquired immune deficiency syndrome: clinical and neuropathological findings in 27 patients. Ann Neurol 1986, 19:224-238.

[13] 13. Ostertag CB, Mennel HD, Kiesling M. Stereotactic biopsy of brain tumours. Surg Neurol 1980, 14:275-283.

[14] 14. Russell DS, Rubinstein L.J. Pathology of Tumours of the Nervous System. Ed5. London: Edward Arnold, 1989.

[15] 15. Taratuto AL, Sevlever G, Piccardo P. Clues and pitfalls in stereotaxic biopsy of the central nervous system. Arch Pathol Lab Med 1991, 115:596-602.

[16] 16. Torres LFB. Citopatologia do sistema nervoso: critérios diagnósticos para análise de esfregaços de tumores do sistema nervoso. XIII Congresso Brasileiro de Citopatologia, 1991.

[17] 17. Torres LFB, Almeida R, Avila S, Alessi S, Freitas R. Brains tumours in South Brazil: a retrospective study of 438 cases. Arq Neuro-Psiquiat (São Paulo) 1990, 48:279-285.

[18] 18. Torres LFB, Collaço LM. Análise citológica per-operatória de lesões do sistema nervoso central e periférico. Anais do XVIII Congresso Latino Americano de Patologia 1991, 1:101 (Abst).

[19] 19. World Health Organization. Histological Typing of Tumors of the Central Nervous System. Geneva: WHO, 1991.

[20] 20. Zhang YX, Luo KS, Liv JC, Chen Y, Chen YH, Lai RS. Cytological diagnosis of 500 cases of intracranial tumors during craniotomy. Chinese J Clin Cytol 1987, 3:19-27.