Metastatic glioblastoma multiforme in cervical lymph nodes. Report of a case with diagnosis by fine needle aspiration.

Metastatic glioblastoma multiforme is a rare event usually seen in patients with previous and repeated surgery. Fine needle aspiration from enlarged lymph nodes in a patient with cerebral glioblastoma multiforme showed a highly cellular smear with dispersed single cells and cell clusters. The cells had marked pleomorphism, hyperchromasia, coarse chromatin, prominent nucleoli and occasional intranuclear cytoplasmic inclusions. Multinucleate giant cells and marked endothelial proliferation were also seen. The diagnosis of metastatic glioblastoma multiforme was supported by immunohistochemistry, which showed many cells with thick and large cytoplasmic processes with intense immunoreactivity to glial fibrillary acid protein. The differential diagnosis with other metastatic small cell tumors is discussed.