Azarpira Negar, Rakei Mohammad, Mokhtari Maral
Department of Pathology, Transplant Research Center, Nemazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Acta Cytol. 2010 Sep-Oct;54(5 Suppl):1023-6.
Intraoperative imprint cytology has proved to be a valuable tool in the diagnosis of central nervous system (CNS) tumors. Ependymomas are uncommon glial neoplasms of the CNS, arising from ependymal lining of the ventricular system and central canal of the spinal cord. Anaplastic ependymoma is a rare tumor that causes diagnostic difficulties in imprint cytology because of variable cytomorphologic findings.
A 21-year-old girl presented with a history of headache and vomiting. Computed tomography of the head showed hydrocephalus with a large parietal lobe tumor with midline structural shift. Imprint intraoperative cytology revealed a hypercellular smear composed of multiple clusters of small size cells with scant amounts of eosinophilic cytoplasm with high nucleus to cytoplasm ratios. The tumor showed pseudorosettes with glial fibrillary acidic protein and epithelial membrane antigen expression. The diagnosis was made with histologic and immunologic confirmation.
Although imprint cytology is a useful method for making a rapid diagnosis, but immunohistochemical markers play a major role in the final diagnosis.
术中印片细胞学已被证明是诊断中枢神经系统（CNS）肿瘤的一种有价值的工具。室管膜瘤是中枢神经系统罕见的神经胶质瘤，起源于脑室系统的室管膜内衬和脊髓中央管。间变性室管膜瘤是一种罕见的肿瘤，由于细胞形态学表现多样，在印片细胞学中诊断困难。
一名21岁女孩有头痛和呕吐病史。头部计算机断层扫描显示脑积水，伴有一个大的顶叶肿瘤，伴有中线结构移位。术中印片细胞学显示涂片细胞增多，由多个小细胞簇组成，嗜酸性细胞质稀少，核质比高。肿瘤显示有胶质纤维酸性蛋白和上皮膜抗原表达的假菊形团。通过组织学和免疫学证实做出诊断。
虽然印片细胞学是快速诊断的有用方法，但免疫组化标志物在最终诊断中起主要作用。
