Opportunities of cerebrospinal fluid cytology and immunocytochemistry in patients with metastatic brain tumors

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Abstract

Background. Cerebro-spinal fluid cytology is a “golden standart” for diagnostics of primary and metastatic brain tumors, and allows to increase their detectability along with other contemporary methods. However there are some limitations for cytologic method due to small volume of specimen and sparse cellularity. According to literature sensitivity of cytological diagnosis varies from 41.3 to 60 %, which depends on distance from the brain lesion and leptomeningeal spread degree. Metastatic tumour cells are most commonly diagnosed in cerebrospinal fluid, though primary brain tumours are leading. To detect and define a histologic type of metastatic tumour cells in cerebrospinal fluid and clarify their histogenesis an immunocytochemical (ICC) diagnostic is possible to use. Objective: to evaluate the capability of cytomorphological and ICC diagnostics in metastatic brain lesions. Materials and methods. We performed 86 cytological examinations in 39 patients (11 males and 28females aged between 31 and 69 years) diagnosed with breast cancer (n = 24), lung cancer (n = 6), melanoma (n = 5), uterine cancer (n = 1), pancreatic cancer (n = 1), thyroid cancer (n = 1) and pleomorphic soft tissue liposarcoma (n = 1). Results. After ICC examination, several indeterminate results (5 cases of breast cancer and 1 case of metastatic melanoma) were confirmed to be positive; three samples from patients with breast cancer were found to have false negative cytological results. Therefore, the use of ICC examination increased the sensitivity of cytological diagnostics to 81.5 %. Conclusion. ICC significantly expands the capability of cytomorphological analysis of cerebrospinal fluid.

About the authors

M. V. Savostikova

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: savostikovamv@yandex.ru
Moscow

L. Ya. Fomina

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: abv@abvpress.ru
Russian Federation, Moscow

E. S. Fedoseeva

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: abv@abvpress.ru
Russian Federation, Moscow

E. Yu. Furminskaya

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Author for correspondence.
Email: abv@abvpress.ru
Russian Federation, Moscow

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