Cerebrospinal fluid and intraoperative squash cytology of childhood ependymoma
Keywords:
Key words: Ependymoma, squash cytology, CSF cytology, immunocytology, histo-immunopathologyAbstract
Ependymomas are glial neoplasms of central nervous system originated from the ependymal lining of the brain ventricles and spinal cord central canal, and rarely exfoliated into cerebrospinal fluid (CSF). In this case we report the cytomorphological and immunocytomorphological features of ependymoma in CSF and intraoperative squash preparations, confirmed by histology. Case report. The patient was a nineteen months old female presented at the University hospital of Heraklion, Crete, in a hemicoma, and was intubated. Computed tomography, scanning and magnetic resonance imaging (MRI), were performed and a mass in the posterior fossa was found. A sample of cerebrospinal fluid (CSF) was sent for cytologic evaluation. A diagnosis of ependymoma was rendered, followed by tumor resection, during which intraoperative squash smears for cytologic interpretation were obtained. Cytological consultation disclosed a grade II ependymoma (WHO grade II), with focally anaplastic features (WHO grade III).
References
Ellison DW, McLendon R, Wiestler OD, Kros JM, Korshunov A, Ng H-K, Witt H, Hirose T. Ependymoma. In: OH LDN, Wiestler OD, Cavenee WK, Ellison DW, Figarella-Branger D, Perry A, Reifenberger G, von Deimling A, editors. WHO classification of Tumours of the central nervous system (revised 4th edition)Lyon: International Agency for Research on Cancer; 2016. pp. 106–111
McGuire CS, Sainani KL, Fisher PG Incidence patterns for ependymoma: a surveillance, epidemiology, and end results study J Neurosurg 2009 110; 725-729
Kulkarni AV,; Bouffet E,; Drake JM . Ependymal tumors: brain and spinal tumors of childhood. 1st ed. London: Arnold; 2004.
Grill J, Le Deley MC, Gambarelli D, et.al. Postoperative chemotherapy without irradiation for ependymoma in children under 5 years of age: a multicenter trial of the French Society of Pediatric Oncology. J Clin Oncol. 2001 Mar 1;19(5):1288-96
. Zacharoulis, S., Levy, A. S., Chi, S. N., Gardner, S., Rosenblum, M., Miller, D. C,et.al. Outcome for young children newly diagnosed with ependymoma, treated with intensive induction chemotherapy followed by myeloablative chemotherapy and autologous stem cell rescue. Pediatric Blood and Cancer, 2007 49(1), 34-40
Adams JH, Graham DI, Doyle D. London: Chapman and Hall; 1981. Brain Biopsy: the smear technique for neurosurgical biopsies; pp. 11–4
Mitra S, Kumar M, Sharma V, Mukhopadhyay D. Squash preparation: A reliable diagnostic tool in the intraoperative diagnosis of central nervous system tumors. J Cytol; 2010: 27(3):81-5
Agrawal M, Chandrakar SK, Lokwani D, Purohit MR. Squash Cytology in Neurosurgical Practice: A Useful Method in Resource-Limited Setting with Lack of Frozen Section Facility. Journal of Clinical and Diagnostic Research 2014;8(10): 9 – 12.
LBS Balsimelli, JC Oliveira, FÁ Adorno, CA Brites et al Accuracy of Intraoperative Examination in Central Nervous System Lesions: A Study of 133 Cases. Acta Cytol. 2019;63(3):224-232.
SIOP Ependymoma II An international clinical program for the diagnosis and treatment of children, adolescents and young adults with ependymoma January 2017.
Ellison DW, Kocak M, Figarella-Branger D, Felice G, et.al. Histopathological grading of pediatric ependymoma: reproducibility and clinical relevance in European trial cohorts. Journal of Negative Results in Biomedicine 2011; 10(7): 1-13.
Qian X, Goumnerova L, De Girolami V et. al. Cerebrospinal fluid cytology in patients with ependymoma. Cancer Cytopathology 2008;114: 307-14.
Kishore M, P Gupta , Bhardwaj M. Cerebrospinal fluid cytology of choroid plexus tumor: A report of two cases, Cytojournal. 2019; 16: 9.
Kishore S, Thakur B,, Bhardwaj A, Kusum A Diagnostic accuracy of squash cytology and role of GFAP immunoexpression in glial tumors. Indian Journal of Pathology and Oncology, January-March, 2018;5(1):12-17
Sarkar S, Sengupta M, Datta Ch, Chatterjee U, Ghosh SN. Evaluation of intraoperative cytological smears for diagnosis of brain tumors with special reference to immunohistochemistry. Indian J Med Paediatr Oncol. 2017 Jul-Sep; 38(3): 296–301.
Kumar PV. Nuclear Grooves in Ependymoma. Cytologic study of 21 Cases. Acta Cytol 1997; 41:1726-1731
Koh MJ, Yoon SO, Jeon HM, Jeong HJ, Hong SW, Kim SH. Cytologic Features of Giant Cell Ependymoma: A Case Report and Review of the Literatur. Korean J Pathol. 2012 Oct; 46(5): 507–513.
Vitanza NA, Partap S. Pediatric ependymoma. Journal of Child Neurology 2016; 31(12): 1354-1366.
Rogers S, Jones DTW, Ireland A Gottardo NG Unusual paediatric spinal myxopapillary ependymomas: Unique molecular entities or pathological variations on a theme? Journal of Clinical Neuroscience, 50:144-148.
Nair AR, Gopalakrishnan CV, Kapilamoorthy TR, Radhakrishnan N. Rosette forming glioneuronal tumor of the forth ventricle in squash cytology smear. J. Cytol. 2014; 31: 215-217
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