Damiani Domenico, Suciu Voichita, Andreiuolo Felipe, Calderaro Julien, Vielh Philippe
Department of Biopathology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France.
Cancer Cytopathol. 2015 Nov;123(11):644-9. doi: 10.1002/cncy.21633.
Medulloblastoma (MB) is the most common malignant pediatric brain tumor and is currently treated with combined therapies. Recent advances in genetics and protein expression in this entity have led to the elaboration of a new molecular classification, and novel targeted therapies are currently under trial. This objective of this study was to describe the cytomorphologic features of MB in cerebrospinal fluid (CSF).
The authors conducted a retrospective study of 194 CSF samples from 70 pediatric patients who had a history of primary MB. The samples consisted of CSF cytospins that were stained according to the May-Grunwald Giemsa and/or Papanicolaou methods.
In 32 patients, it was possible to establish a confident diagnosis of metastatic MB. Common morphologic features included cell clustering, nuclear irregularity, molding and enlargement, and prominent nucleoli. Multinucleation as well as mitotic and apoptotic figures were less frequently observed. Fifteen samples that presented neither cell clustering nor nuclear molding were classified as suspicious.
Cell clustering with nuclear molding is a key feature for the diagnosis of leptomeningeal metastasis of MB.
髓母细胞瘤（MB）是最常见的儿童恶性脑肿瘤，目前采用联合治疗。该实体在遗传学和蛋白质表达方面的最新进展导致了一种新的分子分类的制定，目前新型靶向治疗正在试验中。本研究的目的是描述脑脊液（CSF）中MB的细胞形态学特征。
作者对70例有原发性MB病史的儿科患者的194份CSF样本进行了回顾性研究。样本包括根据May-Grunwald Giemsa和/或巴氏染色法染色的CSF细胞涂片。
在32例患者中，可以确诊转移性MB。常见的形态学特征包括细胞聚集、核不规则、核嵌压和增大以及明显的核仁。多核以及有丝分裂和凋亡图像较少见。15份既无细胞聚集也无核嵌压的样本被分类为可疑。
细胞聚集伴核嵌压是诊断MB软脑膜转移的关键特征。
