Valor do esfregaço no diagnóstico per-operatório dos tumores provenientes de neurocirurgias

Chimelli, Leila; Campos, Ivelise de Souza

doi:10.1590/S0004-282X1993000200007

Resumos

A técnica do esfregaço no diagnóstico per-operatório de tumores provenientes de neurocirurgias vem sendo utilizada em diversos centros de neuropatologia. Com o objetivo de testar esta técnica, examinamos 137 esfregaços e correlacionamos os aspectos cito e histológicos. Analisamos 12 astrocitomas, 4 astrocitomas anaplásicos, 26 glioblastomas, 7 oligodendrogliomas, 7 ependimomas, 5 meduloblastomas, 8 schwannomas, 17 meningiomas, 13 adenomas de hipófise, 20 metástases e 18 tumores diversos e entidades não neoplásicas. Os resultados mostraram porcentual de acerto de 91,2%, coincidente à literatura. O conhecimento da localização do tumor contribuiu para o acerto diagnóstico e o reconhecimento do tecido normal foi importante inclusive para orientar o neurocirurgião a localizar o tumor. Acreditamos que o esfregaço deva ser mais usado em nosso meio, não só pela simplicidade na sua realização mas também pela precisão diagnostica.

diagnóstico citológico per-operatório; neurocirurgias; técnica do esfregaço

The smear technique has been used for rapid diagnosis of tumors removed in neurosurgeries in many neuropathological centers. In order to> assess the diagnostic accuracy of this technique, we examined 137 smears and made a cytohistological correlation. Our cases include 12 astrocytomas, 4 anaplastic astrocytomas, 26 glioblastomas, 7 oligodendrogliomas, 5 medulloblastomas, 8 schwannomas, 17 meningiomas, 13 pituitary adenomas, 20 metastatic tumors and 18 assorted tumors and non neoplastic lesions. The correct diagnosis was made in 91.2% of the cases which coincides to the literature. The knowledge of the localization and the characteristic morphologic features of some tumors were important for the diagnosis. The ability to recognize normal nervous tissue in smears was important even to help the surgeon to reach the tumor. We believe that the use of smears should be encouraged in our country in view of the simplicity of its preparation and accuracy of results.

intra-operative cytologic diagnosis; neurosurgeries; smear technique

Leila Chimelli; Ivelise de Souza Campos

Departamento de Patologia, Universidade Federal Fluminense (UFF), Niterói

RESUMO

A técnica do esfregaço no diagnóstico per-operatório de tumores provenientes de neurocirurgias vem sendo utilizada em diversos centros de neuropatologia. Com o objetivo de testar esta técnica, examinamos 137 esfregaços e correlacionamos os aspectos cito e histológicos. Analisamos 12 astrocitomas, 4 astrocitomas anaplásicos, 26 glioblastomas, 7 oligodendrogliomas, 7 ependimomas, 5 meduloblastomas, 8 schwannomas, 17 meningiomas, 13 adenomas de hipófise, 20 metástases e 18 tumores diversos e entidades não neoplásicas. Os resultados mostraram porcentual de acerto de 91,2%, coincidente à literatura. O conhecimento da localização do tumor contribuiu para o acerto diagnóstico e o reconhecimento do tecido normal foi importante inclusive para orientar o neurocirurgião a localizar o tumor. Acreditamos que o esfregaço deva ser mais usado em nosso meio, não só pela simplicidade na sua realização mas também pela precisão diagnostica.

Palavras-chave: diagnóstico citológico per-operatório, neurocirurgias, técnica do esfregaço.

SUMMARY

The smear technique has been used for rapid diagnosis of tumors removed in neurosurgeries in many neuropathological centers. In order to> assess the diagnostic accuracy of this technique, we examined 137 smears and made a cytohistological correlation. Our cases include 12 astrocytomas, 4 anaplastic astrocytomas, 26 glioblastomas, 7 oligodendrogliomas, 5 medulloblastomas, 8 schwannomas, 17 meningiomas, 13 pituitary adenomas, 20 metastatic tumors and 18 assorted tumors and non neoplastic lesions. The correct diagnosis was made in 91.2% of the cases which coincides to the literature. The knowledge of the localization and the characteristic morphologic features of some tumors were important for the diagnosis. The ability to recognize normal nervous tissue in smears was important even to help the surgeon to reach the tumor. We believe that the use of smears should be encouraged in our country in view of the simplicity of its preparation and accuracy of results.

key words: intra-operative cytologic diagnosis, neurosurgeries, smear technique.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

Aceite: 21-agosto-1992.

Dra. Leila Chimelli Departamento de Patologia, Hospital Universitário Antônio Pedro -Rua Marquês do Paraná 303 - 24030 Niterói RJ - Brasil.

1. Adams JH, Graham DI, Doyle D. Brain biopsy: the smear techniques for neurosurgical biopsies. London: Chapman and Hall, 1981.
2. Balhuizen JC, Bots GThAM, Schaberg A. The value of cytology in the diagnosis of nypophyseal tumors. Acta Cytol 1974, 18:370-375.
3. Beckerley BB, Adams JH, Doyle D, Graham DI, Harper CG. The smear technique in the diagnosis of neurosurgical biopsies. N Z Med J 1978, 87:12-15.
4. 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.
5. Daumas-Duport C, Scheithauer BW, Kelly PJ. A histologic and cytologic method for the spatial definition of gliomas. Mayo Clin Proc 1987, 62:435-449.
6. Enriquez R, Egbert B, Bullock J, Haven W. Primary malignant melanoma of central nervous system. Arch Pathol 1973, 95:392-395.
7. Galloway FG, Roessmann U. Anaplastic astrocytoma mimicking metastatic carcinoma. Am J Surg Pathol 1986, 10:728-732.
8. Gandolfi A. The cytology of cerebral neuroblastoma. Acta Cytol 1980, 24:344-346.
9. Jane JA, Bertrand G. A cytological method for the diagnosis of tumors affecting the central nervous system. J Neuropathol Exp Neurol 1962, 21:400-409.
10. Daing RW, Smith CML. A useful technique for improving the diagnostic yield from single stereotactic biopsies of brain. Neuropathol Appl Neurobiol 1990, 16:529.
11. Larson CP, Reberger CC. Smear method for rapid diagnosis of neurosurgical material. Am J Clin Path 1952, 22:916.
12. Liwnicz BH, Henderson KS, Mazukawa T, Smith RD. Needle aspiration cytology of intracranial lesions: a review of 84 cases. Acta cytol 1982, 26:779-786.
13. Marshall DF, Adams H, Doyle D, Graham DI. The histological accuracy of the smear technique for neurosurgical biopsies. J Neurosurg 1973, 39:82-88.
14. Marshall DF, Jennett B. Smear biopsy in neurosurgical diagnosis. Arch Neurol 1973, 1960 33:471-479.
15. McMenemey WH. An appraisal of smear-diagnosis in neurosurgery. Am J Clin Pathol 1960, 33:471-479.
16. Miguel J, Calvo W, Rubinstein LJ. A simple and rapid stain for the biopsy diagnosis of brain tumors. J Neuropathol Exp Neurol 1968, 27:517-523.
17. Morris AA. The use of smear technique in the rapid histological diagnosis of tumors of the central nervous system. Description of a new staining method. J Neurosurg 1947, 4:497-504.
18. Ostertag CB, Mennel HD, Kiessling M. Stereotactic biopsy of brain tumors. Surg Neurol 1980, 14:275-283.
19. Owings RM. Rapid cytologic examination of surgical specimens: a valuable technique in the surgical pathology laboratory. Human Pathol 1984, 15:605-614.
20. Papo I, Beduschi A, D'Andrea F. II metodo per schiacciamento e striscio nella diag-nosi peroperatoria dei tumori endocranici. Acta Neurol (Napoli) 1956, 11:1182-1194.
21. Papo I, Colombo F. Possibilità e limite dell'esame estemporaneo per shiacciamento e striscio nella diagnosi peroperatoria dei tumori endocranici. Minerva Neurochirurg 1959, 3:134-147.
22. Taratuto AD, Sevlever G, Piccardo P. Clues and pitfalls in stereotactic biopsy of the central nervous system. Arch Path Dab Med 1991, 115:596-602.
23. Torres DFB, Collaço DM. Diagnóstico citopatológico de tumores neuroepiteliais pela técnica do esfregaço. Arq Neuro-Psiquiat (São Paulo) 1992, 50:173-179.
24. Watson CW, Hadju SI. Cytology of primary neoplasms of the central nervous system. Acta Cytol 1977, 21:40-47.
25. Willems JC, Alva-Willems JM, Accuracy of cytologic diagnosis of central nervous system neoplasms in stereotactic biopsies. Acta Cytol 1984, 28:243-249.
26. Yashon D, Jane JA. Central nervous system tissue cytology. Progr Exp Tumor Res 1972, 17:346-362.
27. Zaharapoulos P, Wong JY. Cytology of common primary midline brain tumors. Acta Cytol 1980, 24:384-390.

Valor do esfregaço no diagnóstico per-operatório dos tumores provenientes de neurocirurgias

Value of the smear in the rapid diagnosis of tumors removed in neurosurgeries

Datas de Publicação

Publicação nesta coleção
19 Jan 2011
Data do Fascículo
Jun 1993

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

[1] 1. Adams JH, Graham DI, Doyle D. Brain biopsy: the smear techniques for neurosurgical biopsies. London: Chapman and Hall, 1981.

[2] 2. Balhuizen JC, Bots GThAM, Schaberg A. The value of cytology in the diagnosis of nypophyseal tumors. Acta Cytol 1974, 18:370-375.

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

[4] 4. 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.

[5] 5. Daumas-Duport C, Scheithauer BW, Kelly PJ. A histologic and cytologic method for the spatial definition of gliomas. Mayo Clin Proc 1987, 62:435-449.

[6] 6. Enriquez R, Egbert B, Bullock J, Haven W. Primary malignant melanoma of central nervous system. Arch Pathol 1973, 95:392-395.

[7] 7. Galloway FG, Roessmann U. Anaplastic astrocytoma mimicking metastatic carcinoma. Am J Surg Pathol 1986, 10:728-732.

[8] 8. Gandolfi A. The cytology of cerebral neuroblastoma. Acta Cytol 1980, 24:344-346.

[9] 9. Jane JA, Bertrand G. A cytological method for the diagnosis of tumors affecting the central nervous system. J Neuropathol Exp Neurol 1962, 21:400-409.

[10] 10. Daing RW, Smith CML. A useful technique for improving the diagnostic yield from single stereotactic biopsies of brain. Neuropathol Appl Neurobiol 1990, 16:529.

[11] 11. Larson CP, Reberger CC. Smear method for rapid diagnosis of neurosurgical material. Am J Clin Path 1952, 22:916.

[12] 12. Liwnicz BH, Henderson KS, Mazukawa T, Smith RD. Needle aspiration cytology of intracranial lesions: a review of 84 cases. Acta cytol 1982, 26:779-786.

[13] 13. Marshall DF, Adams H, Doyle D, Graham DI. The histological accuracy of the smear technique for neurosurgical biopsies. J Neurosurg 1973, 39:82-88.

[14] 14. Marshall DF, Jennett B. Smear biopsy in neurosurgical diagnosis. Arch Neurol 1973, 1960 33:471-479.

[15] 15. McMenemey WH. An appraisal of smear-diagnosis in neurosurgery. Am J Clin Pathol 1960, 33:471-479.

[16] 16. Miguel J, Calvo W, Rubinstein LJ. A simple and rapid stain for the biopsy diagnosis of brain tumors. J Neuropathol Exp Neurol 1968, 27:517-523.

[17] 17. Morris AA. The use of smear technique in the rapid histological diagnosis of tumors of the central nervous system. Description of a new staining method. J Neurosurg 1947, 4:497-504.

[18] 18. Ostertag CB, Mennel HD, Kiessling M. Stereotactic biopsy of brain tumors. Surg Neurol 1980, 14:275-283.

[19] 19. Owings RM. Rapid cytologic examination of surgical specimens: a valuable technique in the surgical pathology laboratory. Human Pathol 1984, 15:605-614.

[20] 20. Papo I, Beduschi A, D'Andrea F. II metodo per schiacciamento e striscio nella diag-nosi peroperatoria dei tumori endocranici. Acta Neurol (Napoli) 1956, 11:1182-1194.

[21] 21. Papo I, Colombo F. Possibilità e limite dell'esame estemporaneo per shiacciamento e striscio nella diagnosi peroperatoria dei tumori endocranici. Minerva Neurochirurg 1959, 3:134-147.

[22] 22. Taratuto AD, Sevlever G, Piccardo P. Clues and pitfalls in stereotactic biopsy of the central nervous system. Arch Path Dab Med 1991, 115:596-602.

[23] 23. Torres DFB, Collaço DM. Diagnóstico citopatológico de tumores neuroepiteliais pela técnica do esfregaço. Arq Neuro-Psiquiat (São Paulo) 1992, 50:173-179.

[24] 24. Watson CW, Hadju SI. Cytology of primary neoplasms of the central nervous system. Acta Cytol 1977, 21:40-47.

[25] 25. Willems JC, Alva-Willems JM, Accuracy of cytologic diagnosis of central nervous system neoplasms in stereotactic biopsies. Acta Cytol 1984, 28:243-249.

[26] 26. Yashon D, Jane JA. Central nervous system tissue cytology. Progr Exp Tumor Res 1972, 17:346-362.

[27] 27. Zaharapoulos P, Wong JY. Cytology of common primary midline brain tumors. Acta Cytol 1980, 24:384-390.