BACKGROUND: Ependymoma cells are known to occasionally exfoliate into cerebrospinal fluid (CSF). However, the frequency of CSF involvement in patients with ependymoma is unclear, and to the authors' knowledge the cytomorphologic features of the tumor cells have not been described in detail to date. In this study, the CSF findings in patients with ependymal neoplasms are summarized and the cytomorphologic features of ependymoma, including its variants, are illustrated. METHODS: A search of the pathology databases of 2 medical centers was performed to identify all patients with a histologic diagnosis of ependymoma in whom CSF samples were examined. Slides from CSF samples originally reported as atypical, suspicious, or positive were reviewed and the cytomorphologic features assessed. Follow-up included a review of the medical records and histologic correlation. RESULTS: In all, 177 patients with a diagnosis of ependymoma were identified. Of these, 48 had a total of 94 cytologic preparations of CSF. Positive, suspicious, atypical, negative, and nondiagnostic results were noted in 6.4%, 5.3%, 4.3%, 79.7%, and 4.3%, respectively, of the specimens. The detection rate of tumor cells in CSF was 6.7% in 15 adults and 21.2% in 33 children, with an overall rate of 16.7%. Of the 8 patients with positive and/or suspicious diagnoses, 5 ependymomas exhibited anaplastic features and 1 tumor was a myxopapillary ependymoma. The positive samples were usually hypercellular, with cohesive epithelioid cells; long cytoplasmic processes resembling bipolar tanycytes were observed in the tanycytic variant of ependymoma. CONCLUSIONS: Exfoliated cells from ependymomas are recognizable in CSF samples, especially in patients with myxopapillary tumors and tumors with anaplastic features.
BACKGROUND:Ependymoma cells are known to occasionally exfoliate into cerebrospinal fluid (CSF). However, the frequency of CSF involvement in patients with ependymoma is unclear, and to the authors' knowledge the cytomorphologic features of the tumor cells have not been described in detail to date. In this study, the CSF findings in patients with ependymal neoplasms are summarized and the cytomorphologic features of ependymoma, including its variants, are illustrated. METHODS: A search of the pathology databases of 2 medical centers was performed to identify all patients with a histologic diagnosis of ependymoma in whom CSF samples were examined. Slides from CSF samples originally reported as atypical, suspicious, or positive were reviewed and the cytomorphologic features assessed. Follow-up included a review of the medical records and histologic correlation. RESULTS: In all, 177 patients with a diagnosis of ependymoma were identified. Of these, 48 had a total of 94 cytologic preparations of CSF. Positive, suspicious, atypical, negative, and nondiagnostic results were noted in 6.4%, 5.3%, 4.3%, 79.7%, and 4.3%, respectively, of the specimens. The detection rate of tumor cells in CSF was 6.7% in 15 adults and 21.2% in 33 children, with an overall rate of 16.7%. Of the 8 patients with positive and/or suspicious diagnoses, 5 ependymomas exhibited anaplastic features and 1 tumor was a myxopapillary ependymoma. The positive samples were usually hypercellular, with cohesive epithelioid cells; long cytoplasmic processes resembling bipolar tanycytes were observed in the tanycytic variant of ependymoma. CONCLUSIONS: Exfoliated cells from ependymomas are recognizable in CSF samples, especially in patients with myxopapillary tumors and tumors with anaplastic features.
Authors: Martin Benesch; Martin Mynarek; Hendrik Witt; Monika Warmuth-Metz; Torsten Pietsch; Brigitte Bison; Stefan M Pfister; Kristian W Pajtler; Marcel Kool; Ulrich Schüller; Klaus Pietschmann; Björn-Ole Juhnke; Stephan Tippelt; Gudrun Fleischhack; Irene Schmid; Christof M Kramm; Peter Vorwerk; Andreas Beilken; Carl Friedrich Classen; Pablo Hernáiz Driever; Gabriele Kropshofer; Thomas Imschweiler; Andreas Lemmer; Rolf-Dieter Kortmann; Stefan Rutkowski; Katja von Hoff Journal: Oncologist Date: 2019-03-08
Authors: Yvis del Mar Ortiz; Juan L Pérez Berenguer; Juan Mercado Acosta; Mario Polo; Orlando de Jesús-Garces; Irving E Vega Journal: Int J Clin Exp Pathol Date: 2014-10-15
Authors: Philipp Karschnia; Frank J Barbiero; Michaela H Schwaiblmair; Leon D Kaulen; Joseph M Piepmeier; Anita J Huttner; Kevin P Becker; Robert K Fulbright; Joachim M Baehring Journal: Neurooncol Pract Date: 2019-07-06