Central Nervous System Intraoperative Cytopathology by César R. Lacruz Javier Sáenz de Santamaría & Ricardo H. Bardales

Author:César R. Lacruz, Javier Sáenz de Santamaría & Ricardo H. Bardales
Language: eng
Format: epub
Publisher: Springer New York, New York, NY

Fig. 10.4.Cerebral neuroblastoma. The most characteristic features are the presence of rosettes with central nucleus-free areas of neuropil (a), and small cells with unipolar cytoplasmic extensions (b) ((a, b) Smears. (a) H&E, (b) Romanowsky).

Differential Diagnosis Considerations

The cytologic differential diagnosis includes such other small malignant tumors as lymphoma, metastatic small cell carcinoma, and high-grade gliomas. Clinical and radiologic data are necessary for a diagnosis, which is usually sufficient in pediatric cases. The main problem in adults is metastatic small cell carcinoma. An extracerebellar location, the presence of multiple lesions, the existence of a lung lesion, and the absence of neoplastic glial/neuronal differentiation point toward a metastatic tumor. In the chapter on normal CNS cytology, we already mentioned that the inexperienced must be aware of interpreting smears with cerebellar granular cells as medulloblastoma (Table 10.1).Table 10.1.Characteristics of medulloblastoma/PNETs.

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