Fernandes S P, Penchansky L
Department of Pathology, University of Pittsburgh, PA 15213, USA.
Pediatr Pathol Lab Med. 1996 Sep-Oct;16(5):721-9.
Cerebrospinal fluid (CSF) samples from four infants 3 days to 4 months of age with a history of prematurity or birth trauma were found to contain clusters of immature cells. These cells were arranged in groups or syncytia, sometimes with nuclear molding, and were cytologically characterized by scant basophilic cytoplasm, nuclei with fine nuclear chromatin, and small nucleoli. The picture simulated the appearance of metastatic tumor admixed with hemosiderin-laden macrophages, erythrocytes, and leukocytes. Because of the low numbers of cells or aggregates present in CSF samples and the relatively small quantity of CSF obtained, immunohistochemical and flow cytometric evaluations were not performed. Prior studies have designated these immature cells as undifferentiated leptomeningeal cells or cells from the subependymal germinal matrix and have associated their presence with intraventricular hemorrhage (IVH) in premature newborns. Three of our patients had a history of prematurity; the fourth patient suffered a traumatic birth but was not premature. In long-term follow-up, the patients have not shown progression of neurologic deficits or evidence of malignancy. Thus, it is important to recognize that in infants with a history of IVH, subarachnoid hemorrhage, or ventricular drainage devices, the presence of tumorlike clumps of cells associated with hemosiderin-laden macrophages most likely does not represent metastatic tumor.
从4名年龄在3天至4个月、有早产或出生创伤史的婴儿的脑脊液（CSF）样本中发现含有不成熟细胞簇。这些细胞成组或融合体排列，有时有核型，细胞学特征为嗜碱性细胞质稀少、核染色质细的细胞核和小核仁。该图像类似于混合有含铁血黄素巨噬细胞、红细胞和白细胞的转移性肿瘤的外观。由于脑脊液样本中存在的细胞或聚集体数量较少，且获得的脑脊液量相对较少，因此未进行免疫组织化学和流式细胞术评估。先前的研究已将这些不成熟细胞指定为未分化的软脑膜细胞或来自室管膜下生发基质的细胞，并将它们的存在与早产新生儿的脑室内出血（IVH）相关联。我们的3名患者有早产史；第四名患者有分娩创伤但并非早产。在长期随访中，这些患者未出现神经功能缺损进展或恶性肿瘤证据。因此，重要的是要认识到，在有IVH、蛛网膜下腔出血或脑室引流装置病史的婴儿中，与含铁血黄素巨噬细胞相关的肿瘤样细胞团块很可能并不代表转移性肿瘤。
