M. Jorda et al., CYTOLOGIC CHARACTERISTICS OF MENINGEAL CARCINOMATOSIS - INCREASED DIAGNOSTIC-ACCURACY USING CARCINOEMBRYONIC ANTIGEN AND EPITHELIAL MEMBRANE ANTIGEN IMMUNOCYTOCHEMISTRY, Archives of neurology, 55(2), 1998, pp. 181-184
Background and Objectives: Traditionally, the diagnosis of meningeal c
arcinomatosis has been based on clinical suspicion and confirmed by cy
tologic study of cerebrospinal fluid. However, routine cytologic study
may fail to detect malignant cells in a relatively large number of ca
ses. We used immunocytochemistry in an attempt to increase the sensiti
vity of cytologic detection of malignant neoplasms in cerebrospinal fl
uid. Materials and Methods: Thirty-eight consecutive cerebrospinal flu
id specimens from patients with clinically suspected meningeal carcino
matosis were selected for this study. Immunocytochemistry for carcinoe
mbryonic antigen and epithelial membrane antigen were used on the arch
ival Papanicolaou-stained cerebrospinal fluid preparations. Results: O
f the 23 specimens from patients with proven meningeal carcinomatosis,
13 were correctly diagnosed using cytomorphologic criteria alone. The
diagnosis of malignant neoplasm in 8 cytologically suspicious and 1 c
ytologically negative specimen was confirmed using immunocytochemistry
. All cases that were negative on follow-up were also negative cytolog
ically and immunocytochemically. Conclusions: We conclude that in usin
g common antibodies, such as carcinoembryonic antigen and epithelial m
embrane antigen, the sensitivity of the cytologic diagnosis of meninge
al carcinomatosis increases, and that previously Papanicolaou-stained
preparations are suitable for immunocytochemical studies.