Metastatic Breast Carcinoma in Cerebrospinal Fluid: A Cytopathological Review of 15 Cases

Rema Rao, Syed A. Hoda, Alan Marcus, Rana S. Hoda

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

The incidence of metastatic carcinoma to the meninges (“meningeal carcinomatosis” [MC]) is increasing due to longer survival of patients and improved imaging techniques. Currently, MC is best diagnosed by cytopathological evaluation of cerebrospinal fluid (CSF). Breast primaries are the commonest cause of MC; although cytopathological features thereof have not been, as yet, fully characterized. In this study of meningeal mammary carcinomatosis, relevant clinicopathological data and archived cytopathological preparations of all “suspicious” and “positive” CSF specimens (1992–2015), from patients with a history of breast carcinoma, were retrieved and reviewed. Twenty-three “positive” CSF specimens, derived from 15 patients formed the basis of this study. All specimens were processed as Cytospin preparations, and stained by Papanicolaou and Diff-Quik techniques. All patients were female, with a mean age of 57 (range: 32–85) years. Mean interval between initial diagnosis of breast carcinoma and “positive” CSF was 32 (range 6–84) months. All 23 specimens (100%) were “cellular” (>10 carcinoma cells). Eighteen (78%) specimens showed only isolated nonclustered cells, and 5 (22%) specimens showed both cell clusters and isolated cells. In most “positive” cases, metastatic breast carcinoma cells showed variation in cell size, with hyperchromatic nuclei, irregular nuclear membranes, prominent nucleoli and cytoplasmic vacuolization. The background in some CSF samples showed red blood cells and fibrin admixed with rare lymphocytes and histiocytes. One specimen showed necrotic debris. Papanicolaou and Diff-Quik-stained Cytospin preparations were equally diagnostic, as the aforementioned findings were present in both types of preparation.

Original languageEnglish (US)
Pages (from-to)456-460
Number of pages5
JournalBreast Journal
Volume23
Issue number4
DOIs
StatePublished - Jul 1 2017
Externally publishedYes

Keywords

  • breast carcinoma
  • cerebrospinal fluid
  • cytology
  • metastasis

ASJC Scopus subject areas

  • Internal Medicine
  • Surgery
  • Oncology

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