Cerebrospinal fluid cytomorphologic findings in 41 intracranial tumors: a retrospective review

Alterações citomorfológicas do líquido céfalo-raquidiano em 41 doentes com tumores intracranianos: estudo retrospectivo

Abstracts

The main objective of this retrospective review of clinical and cerebrospinal fluid (CSF) data from 41 patients with intracranial tumors diagnosed between 1975 and 1989, is to report the role that the finding of neoplastic cells in CSF plays, specially when cerebral CT-scanning and MRI were not currently done. Another objective is to study the CSF proteic abnormalities in cerebral tumors. CSF cell count, cytomorphologic pictures obtained after sedimentation and protein findings are described. Tumor cells were seen in 12 cases (29%): medulloblastomas - 6, meningeal carcinomatosis - 3, multiforme glioblastoma - 1, ependymoma -1, cerebral metastasis -1; in two cases it was an unexpected finding. We noticed that tumoral localization next to the ventricles favoured cell exfoliation. Although pleocytosis was rare and uncorrelated with the presence of neoplastic cells, pathological cytomorphologic pictures appeared in most of the cases including all "positive" ones. Our results stress that the appearance of neoplastic cells in CSF remains helpful specially when it is an unexpected finding.

CSF cytology; CSF tumor cells; cerebral tumors


O objectivo fundamental desta revisão retrospectiva dos dados clínicos e do estudo do líquido céfalo-raquidiano (LCR) de 41 doentes com tumores intracranianos diagnosticados entre 197S e 1989 é analisar a importância do achado de células neoplásicas no LCR, principalmente quando o recurso à tomografia computorizada e ressonância magnética cerebrais era raro. Outro objectivo diz respeito ao estudo das alterações proteicas do LCR nos tumores cerebrais. A análise do LCR compreendeu a contagem celular, a observação dos quadros citomorfológicos obtidos após sedimentação, o doseamento das proteínas totais e a determinação dos perfis electroforéticos. Encontraram-se células tumorais em 12 doentes (29%): meduloblastomas - 6, meningites carcinomatosas - 3, glioblastoma multiforme - 1, ependimoma -1, metastases cerebrais -1; em 2 casos este achado foi inesperado. Na maior parte dos casos a localização do tumor perto do sistema ventricular favoreceu a exfoliação celular. Embora a pleocitose fosse rara e não se correlacionasse com a presença de células neoplásicas, verificámos que na maioria dos casos, incluindo todos aqueles com citologia "positiva", os quadros citomorfológicos eram patológicos. Os nossos resultados mostram que a pesquisa de células tumorais no LCR continua a ser util e o seu achado particularmente relevante quando inesperado.

citologia do LCR; células tumorais no LCR; tumores cerebrais


Cerebrospinal fluid cytomorphologic findings in 41 intracranial tumors: a retrospective review

Alterações citomorfológicas do líquido céfalo-raquidiano em 41 doentes com tumores intracranianos: estudo retrospectivo

Maria José SáI; Rui VazII; Celso CruzIII

IM.D. - Assistente de Neurologia do Serviço de Neurologia e Neurocirurgia do Hospital de S.João (Porto, Portugal), Membro do "CSF Research Group" - World Federation of Neurology

IIM.D.- Assistente de Neurocirurgia do Serviço de Neurologia e Neurocirurgia do Hospital de S.João (Porto, Portugal)

IIIPh.D.-Professor Catedrático de Neurologia e Neurocirurgia da Faculdade de Medicina do Porto, Director do Serviço de Neurologia e Neurocirurgia do Hospital de S. João (Porto, Portugal)

SUMMARY

The main objective of this retrospective review of clinical and cerebrospinal fluid (CSF) data from 41 patients with intracranial tumors diagnosed between 1975 and 1989, is to report the role that the finding of neoplastic cells in CSF plays, specially when cerebral CT-scanning and MRI were not currently done. Another objective is to study the CSF proteic abnormalities in cerebral tumors. CSF cell count, cytomorphologic pictures obtained after sedimentation and protein findings are described. Tumor cells were seen in 12 cases (29%): medulloblastomas - 6, meningeal carcinomatosis - 3, multiforme glioblastoma - 1, ependymoma -1, cerebral metastasis -1; in two cases it was an unexpected finding. We noticed that tumoral localization next to the ventricles favoured cell exfoliation. Although pleocytosis was rare and uncorrelated with the presence of neoplastic cells, pathological cytomorphologic pictures appeared in most of the cases including all "positive" ones. Our results stress that the appearance of neoplastic cells in CSF remains helpful specially when it is an unexpected finding.

Key words:CSF cytology, CSF tumor cells, cerebral tumors.

RESUMO

O objectivo fundamental desta revisão retrospectiva dos dados clínicos e do estudo do líquido céfalo-raquidiano (LCR) de 41 doentes com tumores intracranianos diagnosticados entre 197S e 1989 é analisar a importância do achado de células neoplásicas no LCR, principalmente quando o recurso à tomografia computorizada e ressonância magnética cerebrais era raro. Outro objectivo diz respeito ao estudo das alterações proteicas do LCR nos tumores cerebrais. A análise do LCR compreendeu a contagem celular, a observação dos quadros citomorfológicos obtidos após sedimentação, o doseamento das proteínas totais e a determinação dos perfis electroforéticos. Encontraram-se células tumorais em 12 doentes (29%): meduloblastomas - 6, meningites carcinomatosas - 3, glioblastoma multiforme - 1, ependimoma -1, metastases cerebrais -1; em 2 casos este achado foi inesperado. Na maior parte dos casos a localização do tumor perto do sistema ventricular favoreceu a exfoliação celular. Embora a pleocitose fosse rara e não se correlacionasse com a presença de células neoplásicas, verificámos que na maioria dos casos, incluindo todos aqueles com citologia "positiva", os quadros citomorfológicos eram patológicos. Os nossos resultados mostram que a pesquisa de células tumorais no LCR continua a ser util e o seu achado particularmente relevante quando inesperado.

Palavras-chave: citologia do LCR, células tumorais no LCR, tumores cerebrais.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Acknowledgements

The authors are indebted to the medical staff of the Neurology and Neurosurgery Department of Hospital de S.João for making clinical data available. We are also grateful to Mr.Óscar Campos for technical assistance in the CSF studies.

Aceite: 5-novembro-1994.

Dra. Maria José Sá - Serviço de Neurologia e Neurocirurgia, Hospital de S. João - Al. Prof. Hernâni Monteiro -4200 Porto, Portugal Fax (3512) 598119.

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Publication Dates

  • Publication in this collection
    20 Jan 2011
  • Date of issue
    June 1995
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