Fig. 1Operation for ventricular catheter and reservoir placement. A localized area of the skull is removed (A), and the reservoir is placed in the defect area (B).
Fig. 2Low (A) and high (B) power views of cerebrospinal fluid in a patient with metastatic adenocarcinoma of the lung. Separate case showing an atypical cell (C) confirmed as metastatic carcinoma using immunocytochemistry for cytokeratin (D).
Table 1.Clinicopathologic features of 42 cases and diagnostic rates of cerebrospinal fluid cytology
Case No. |
Sex |
Age (yr) |
Primary site |
Histologic type |
Period (mo) |
Total |
Negative rate |
Positive rate |
1 |
M |
48 |
Lung |
Adenocarcinoma |
1 |
6 |
3 (50.0) |
3 (50.0) |
2 |
M |
63 |
Lung |
Adenocarcinoma |
1 |
4 |
2 (50.0) |
2 (50.0) |
3 |
F |
60 |
Ovary |
Serous papillary carcinoma |
8 |
13 |
10 (76.9) |
3 (23.1) |
4 |
M |
64 |
Lung |
Adenocarcinoma |
2 |
13 |
7 (53.8) |
6 (46.2) |
5 |
M |
56 |
Rectum |
Adenocarcinoma |
7 |
12 |
12 (100.0) |
0 (0) |
6 |
F |
56 |
Breast |
Invasive ductal carcinoma |
5 |
11 |
10 (90.9) |
1 (9.1) |
7 |
F |
43 |
Lung |
Adenocarcinoma |
3 |
13 |
8 (61.5) |
5 (38.5) |
8 |
M |
58 |
Lung |
Adenocarcinoma |
11 |
22 |
19 (86.0) |
3 (14.0) |
9 |
M |
52 |
Kidney |
Renal cell carcinoma |
5 |
9 |
9 (100.0) |
0 (0.0) |
10 |
F |
66 |
Lung |
Adenocarcinoma |
22 |
22 |
21 (95.5) |
1 (4.5) |
11 |
M |
66 |
Lung |
Adenocarcinoma |
1 |
2 |
0 (0.0) |
2 (100.0) |
12 |
M |
58 |
Lung |
Adenocarcinoma |
2 |
15 |
5 (33.3) |
10 (66.7) |
13 |
M |
62 |
Lung |
Adenocarcinoma |
21 |
34 |
18 (52.9) |
16 (47.1) |
14 |
M |
65 |
Stomach |
Adenocarcinoma |
1 |
7 |
2 (28.6) |
5 (71.4) |
15 |
M |
66 |
Lung |
Adenocarcinoma |
6 |
15 |
12 (80.0) |
3 (20.0) |
16 |
F |
58 |
Lung |
Adenocarcinoma |
4 |
17 |
11 (64.7) |
6 (35.3) |
17 |
M |
29 |
Stomach |
Signet ring cell carcinoma |
3 |
9 |
4 (44.4) |
5 (55.6) |
18 |
M |
51 |
Lung |
Adenocarcinoma |
1 |
3 |
0 (0.0) |
3 (100.0) |
19 |
F |
71 |
Lung |
Adenocarcinoma |
1 |
4 |
1 (25.0) |
3 (75.0) |
20 |
F |
74 |
Ovary |
Serous papillary carcinoma |
3 |
8 |
0 (0.0) |
8 (100.0) |
21 |
M |
64 |
Stomach |
Adenocarcinoma |
1 |
4 |
0 (0.0) |
4 (100.0) |
22 |
M |
52 |
Lung |
Adenocarcinoma |
1 |
8 |
1 (12.5) |
7 (87.5) |
23 |
F |
58 |
Stomach |
Adenocarcinoma |
1 |
3 |
0 (0.0) |
3 (100.0) |
24 |
M |
65 |
Lung |
Adenocarcinoma |
9 |
14 |
12 (85.7) |
2 (14.3) |
25 |
F |
47 |
Breast |
Invasive ductal carcinoma |
1 |
2 |
0 (0.0) |
2 (100.0) |
26 |
F |
40 |
Breast |
Invasive ductal carcinoma |
11 |
7 |
2 (28.6) |
5 (71.4) |
27 |
F |
56 |
Breast |
Invasive ductal carcinoma |
1 |
2 |
0 (0.0) |
2 (100.0) |
28 |
M |
65 |
Lung |
Small cell carcinoma |
4 |
4 |
3 (75.0) |
1 (25.0) |
29 |
M |
51 |
Skin |
Malignant melanoma |
1 |
2 |
0 (0.0) |
2 (100.0) |
30 |
F |
46 |
Breast |
Invasive ductal carcinoma |
5 |
18 |
17 (94.4) |
1 (5.6) |
31 |
M |
55 |
Urinary bladder |
Urothelial carcinoma |
1 |
2 |
1 (50.0) |
1 (50.0) |
32 |
M |
41 |
Lung |
Adenocarcinoma |
2 |
11 |
3 (27.3) |
8 (72.7) |
33 |
M |
53 |
Lung |
Adenocarcinoma |
2 |
8 |
7 (87.5) |
1 (12.5) |
34 |
M |
55 |
Lung |
Adenocarcinoma |
8 |
7 |
1 (14.3) |
6 (85.7) |
35 |
F |
46 |
Breast |
Invasive ductal carcinoma |
5 |
3 |
3 (100.0) |
0 (0.0) |
36 |
M |
39 |
Pancreas |
Adenocarcinoma |
6 |
7 |
5 (71.4) |
2 (28.6) |
37 |
F |
65 |
Breast |
Invasive ductal carcinoma |
5 |
13 |
6 (46.2) |
7 (53.8) |
38 |
M |
31 |
Skin |
Malignant melanoma |
2 |
4 |
3 (75.0) |
1 (25.0) |
39 |
F |
46 |
Breast |
Invasive ductal carcinoma |
1 |
4 |
2 (50.0) |
2 (50.0) |
40 |
F |
49 |
Lung |
Adenocarcinoma |
10 |
8 |
3 (37.5) |
5 (62.5) |
41 |
M |
49 |
Lung |
Adenocarcinoma |
1 |
9 |
0 (0.0) |
9 (100.0) |
42 |
F |
77 |
Lung |
Adenocarcinoma |
1 |
6 |
3 (50.0) |
3 (50.0) |
Mean |
|
|
|
|
5 |
385 |
226 (58.7) |
159 (41.3) |
Table 2.Consecutive cerebrospinal fluid cytology results of case no. 4 and case no. 12
Case No. 4 |
Cytological diagnosis |
Date |
Case No. 12 |
Cytological diagnosis |
Date |
1 |
Negative for malignancy |
Oct 20, 2010 |
1 |
Positive for malignancy |
Feb 5, 2013 |
2 |
Positive for malignancy |
Oct 23, 2010 |
2 |
Positive for malignancy |
Feb 15, 2013 |
3 |
Negative for malignancy |
Oct 30, 2010 |
3 |
Negative for malignancy |
Feb 25, 2013 |
4 |
Positive for malignancy |
Nov 2, 2010 |
4 |
Positive for malignancy |
Feb 27, 2013 |
5 |
Positive for malignancy |
Nov 8, 2010 |
5 |
Positive for malignancy |
Mar 5, 2013 |
6 |
Negative for malignancy |
Nov 10, 2010 |
6 |
Positive for malignancy |
Mar 6, 2013 |
7 |
Suspicious for malignancy |
Nov 23, 2010 |
7 |
Negative for malignancy |
Mar 12, 2013 |
8 |
Positive for malignancy |
Nov 24, 2010 |
8 |
Positive for malignancy |
Mar 14, 2013 |
9 |
Negative for malignancy |
Nov 24, 2010 |
9 |
Positive for malignancy |
Mar 18, 2013 |
10 |
Negative for malignancy |
Dec 1, 2010 |
10 |
Negative for malignancy |
Mar 21, 2013 |
11 |
Suspicious for malignancy |
Dec 3, 2010 |
11 |
Positive for malignancy |
Mar 26, 2013 |
12 |
Negative for malignancy |
Dec 9, 2010 |
12 |
Negative for malignancy |
Mar 27, 2013 |
13 |
Negative for malignancy |
Dec 16, 2010 |
13 |
Positive for malignancy |
Mar 29, 2013 |
|
|
|
14 |
Negative for malignancy |
Apr 2, 2013 |
|
|
|
15 |
Positive for malignancy |
Apr 3, 2013 |