CSF/brain smear cytology - Rcpa.tv

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Tumours of meningothelial cells:Meningioma:-more single cells in the background, as compared to schwannoma-whorls, syncytial groups, fascicles-cells may look 'epithelioid', mimicking a carcinoma but they are very uniform in size-round to oval nuclei, intranuclear inclusions, indistinct nucleoli-psammoma bodiesAtypical meningioma:-some cells may show nuclear atypia: high N/C ratio with small cells; prominentnucleoli-mitoses and necrosis may be seenAnaplastic (malignant) meningioma:-there is usually a loss of meningothelial differentiation, in which the cells resemble acarcinoma, melanoma or sarcomaMesenchymal tumours:Haemangiopericytoma:-cohesive groups with irregular edges and single cells-tumour cells with high N/C ratio, hyperchromatic ovoid nuclei, small nucleoli andscanty cytoplasmPrimary melanocytic lesions:Malignant melanoma:-single cells-large eccentric, pleomorphic nuclei with prominent nucleoli-binucleation, intranuclear pseudoinclusions-cytoplasmic pigmentOther tumours related to the meninges:Haemangioblastoma:-smears poorly-densely vascular thick clumps of cells-oval medium-sized nuclei, indistinct cytoplasm-the typical vascular network is poorly visualized on the smears-presence of mast cells is a clue to the diagnosisHaematopoietic tumours:Lymphoma:-the blood vessel walls are often infiltrated by tumour cells (rather than endothelialcell hyperplasia)-single cells with high N/C ratio, prominent nucleoli, scant cytoplasm-lymphoglandular bodies may be seenPlasmacytoma:-uniform population of single neoplastic plasma cells-plasmacytoid differentiation: eccentric nuclei, ‘clockface’ chromatin, perinuclear hof-bi and multinucleated forms may be present-some cells may show blastic features with prominent nucleoli
-Dutcher (intranuclear) and Russell (extra/intracytoplasmic) bodies seen-amyloid may be seen in some casesGranulocytic sarcoma:-hypercellular infiltrate of single tumour cells-appearances depending on type of leukaemia-cells generally have more convoluted nuclei and slightly more cytoplasm, ascompared with lymphoma-may see cytoplasmic granules and Auer rods with myeloid cellsLangerhans cell histiocytosis:-single tumour cells with enlarged bean-shaped nuclei and intranuclear grooves-prominent eosinophils in the backgroundGerm cell tumours:Germinoma:-cohesive and single tumour cells-cells with pleomorphic nuclei, prominent nucleoli and moderate amounts ofcytoplasm-tigroid background (best seen with Diff-Quik stain)-fibrous septa with lymphocytes are seen, with tumour cells clinging onTumours of the sellar region:Craniopharyngioma:-may have cystic component which is thick dark brown (machinery oil-like) withminute glistening crystals of cholesterol-cohesive epithelial groups with squamous cells, some showing ‘stellate-reticulum’appearance-wet-keratin may be seen with clumps of densely keratinised cells showing loss ofnuclear staining-calcification, cholesterol clefts, chronic inflammation in the backgroundPituitary adenoma:-softer to smear with smooth monolayer-cells usually dyscohesive-may have papillary structures with tumour cells clinging to branching vessels-single population of cells-finely granular chromatin, no nucleoli-no cytoplasm, bare nuclei - more likely to be non-functioning adenomas-with cytoplasm - more likely to be functioning types-functioning adenomas often contain pleomorphic tumour cells (e.g. GH, TSH, ACTHsecreting adenomas)-in prolactinomas with Bromocriptine effect, the tumour cells look similar to smallcell lymphoma (esp. on frozen section)-prolactinomas often contain psammoma bodiesGranular cell tumour:-clusters and single cells with abundant granular cytoplasm, prominent nucleoli-nuclear atypia such as nuclear pleomorphism can be seen-cytoplasm usually not as spindled as in spindle cell oncocytoma
Page 1 and 2: CSF/brain smear cytologyDr Alpha Ts
Page 3 and 4: -foreign material e.g. shunt-parasi
Page 5 and 6: Metastatic melanoma:-cells are larg
Page 7 and 8: Fig 1. Normal CSF. Note hypocellula
Page 9 and 10: Fig 5. Unsatisfactory. Degenerate c
Page 11 and 12: Fig 9. Cryptococcus.Fig 10. Erythro
Page 13 and 14: Fig 13. Metastatic carcinoma with s
Page 15 and 16: Fig 17. Non-Hodgkin lymphoma.Fig 18
Page 17 and 18: Fig 21. Brain fluid cytology: Gliob
Page 19 and 20: -Rosenthal fibres and eosinophilic
Page 21 and 22: -no mitoses, endothelial proliferat
Page 23: Pineal region tumours:Pineocytoma:-
Page 27 and 28: PRACTICAL TIPS:1. Know cellularity
Page 29 and 30: Fig 3. Normal neuron.Fig 4. Normal
Page 31 and 32: Fig 7. Reactive gliosis with increa
Page 33 and 34: Fig 11. Ischaemic (red) neuron with
Page 35 and 36: Fig 15. Sequestrated intervertebral
Page 37 and 38: Fig 19. Gemistocytic astrocytoma.Fi
Page 39 and 40: Fig 23. Pleomorphic xanthoastrocyto
Page 41 and 42: Fig 27. GBM: Necrosis.Fig 28. Glios
Page 43 and 44: Fig 31. Oligodendroglioma. Chicken-
Page 45 and 46: Fig 35. Myxopapillary ependymoma. M
Page 47 and 48: Fig 39. Choroid plexus papilloma wi
Page 49 and 50: Fig 43. Central neurocytoma with a
Page 51 and 52: Fig 47. Schwannoma. Twisted rope pa
Page 53 and 54: Fig 51. Neurofibroma.Fig 52. Mening
Page 55 and 56: Fig 55. Clear cell meningioma.Fig 5
Page 57 and 58: Fig 59. Haemangioblastoma. The typi
Page 59 and 60: Fig 63. ACTH secreting pituitary ad
Page 61 and 62: Fig 67. Spindle cell oncocytoma of
Page 63 and 64: Fig 71. Metastatic carcinoma. Tumou

CSF/brain smear cytology - Rcpa.tv

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