D L Commins1, D R Hinton. 1. Department of Pathology, University of Southern California School of Medicine, Los Angeles, USA.
Abstract
OBJECTIVE: To compare the features of intraoperative smears of hemangioblastomas with those of tumors with which it is most likely to be confused: meningiomas, anaplastic astrocytomas and renal cell carcinomas. STUDY DESIGN: Examples of hemangioblastomas with high-quality intraoperative smears were retrieved from the files of University Hospital, University of Southern California and Los Angeles County-University of Southern California. The characteristics of these smears were compared to those of meningiomas, anaplastic astrocytomas and renal cell carcinomas by two observes. RESULTS: Smears of hemangioblastomas were cellular but remarkably cohesive. Cytoplasmic borders were indistinct. The nuclei were hyperchromatic and mildly pleomorphic and had a relatively evenly dispersed chromatin pattern. Hemosiderin was invariably present. Smears of meningiomas, anaplastic astrocytomas and renal cell carcinomas were more discohesive than those of hemangioblastomas. Smears of hemangioblastomas lacked the cytoplasmic fibrillarity of those of astrocytic neoplasms and distinct cytoplasmic borders seen in smears of renal cell carcinoma. The nuclear features of the four neoplasms studied also differed. CONCLUSION: Smears of hemangioblastomas have characteristic features that differ reliably from those of meningiomas, anaplastic astrocytoma and renal cell carcinoma, neoplasms that commonly enter the differential with hemangioblastoma. Thus, a cytologic smear preparation made at the time of frozen section may be an invaluable aid in the intraoperative diagnosis of hemangioblastoma.
OBJECTIVE: To compare the features of intraoperative smears of hemangioblastomas with those of tumors with which it is most likely to be confused: meningiomas, anaplastic astrocytomas and renal cell carcinomas. STUDY DESIGN: Examples of hemangioblastomas with high-quality intraoperative smears were retrieved from the files of University Hospital, University of Southern California and Los Angeles County-University of Southern California. The characteristics of these smears were compared to those of meningiomas, anaplastic astrocytomas and renal cell carcinomas by two observes. RESULTS: Smears of hemangioblastomas were cellular but remarkably cohesive. Cytoplasmic borders were indistinct. The nuclei were hyperchromatic and mildly pleomorphic and had a relatively evenly dispersed chromatin pattern. Hemosiderin was invariably present. Smears of meningiomas, anaplastic astrocytomas and renal cell carcinomas were more discohesive than those of hemangioblastomas. Smears of hemangioblastomas lacked the cytoplasmic fibrillarity of those of astrocytic neoplasms and distinct cytoplasmic borders seen in smears of renal cell carcinoma. The nuclear features of the four neoplasms studied also differed. CONCLUSION: Smears of hemangioblastomas have characteristic features that differ reliably from those of meningiomas, anaplastic astrocytoma and renal cell carcinoma, neoplasms that commonly enter the differential with hemangioblastoma. Thus, a cytologic smear preparation made at the time of frozen section may be an invaluable aid in the intraoperative diagnosis of hemangioblastoma.