Klysik Michal, Gavito Jose, Boman Darius, Miranda Roberto N, Hanbali Fadi, De Las Casas Luis E
Department of Radiology, University of Colorado at Denver, Aurora, Colorado, USA.
Diagn Cytopathol. 2010 Mar;38(3):202-7. doi: 10.1002/dc.21179.
Intraoperative cytologic evaluation of brain tumors has been used either to render a preliminary interpretation or more often as a complement to frozen section examination. Central neurocytoma is a intraventricular neoplasm, typically located in the region of the foramen of Monro, affecting mostly young to middle age adults. Histologically, central neurocytomas are characterized by monotonous cells with round nuclei and neuronal differentiation within a rich capillary network. Their distinction during intraoperative consultations from oligodendroglioma, ependymoma (mainly clear cell ependymoma), and non-Hodgkin lymphoma can be a diagnostic challenge. We report a case of a 19-year-old female with an intraventricular tumor where imprint cytology preparations were crucial for the intraoperative diagnosis of central neurocytoma. Imprint cytology preparations show a round cell neoplasm associated with neuropil clumps and short straight capillaries admixed with tumor cell clusters. To the best of our knowledge, only a few cases describing the cytologic findings of central neurocytomas have been reported in the medical literature. The differential diagnosis, tissue correlation, clinical-radiologic features, and ancillary studies are discussed.
脑肿瘤的术中细胞学评估要么用于做出初步诊断,要么更常见的是作为冰冻切片检查的补充。中枢神经细胞瘤是一种脑室内肿瘤,通常位于孟氏孔区域,主要影响中青年成年人。从组织学上看,中枢神经细胞瘤的特征是细胞单一,细胞核呈圆形,在丰富的毛细血管网络内具有神经元分化。在术中会诊时,将其与少突胶质细胞瘤、室管膜瘤(主要是透明细胞室管膜瘤)和非霍奇金淋巴瘤区分开来可能是一项诊断挑战。我们报告一例19岁女性的脑室内肿瘤病例,其中印片细胞学制片对中枢神经细胞瘤的术中诊断至关重要。印片细胞学制片显示一个圆形细胞瘤,伴有神经毡团块和短直毛细血管,与肿瘤细胞簇混合存在。据我们所知,医学文献中仅报道了少数描述中枢神经细胞瘤细胞学表现的病例。本文讨论了鉴别诊断、组织相关性、临床影像学特征及辅助检查。