Differences in cerebrospinal fluid inflammatory cell reaction of patients with leptomeningeal involvement by lymphoma and carcinoma

Illán, Julia; Simó, Marta; Serrano, Cristina; Castañón, Susana; Gonzalo, Raquel; Martinez-García, Maria; Pardo, Javier; Gómez, L.; Navarro, Miguel; Altozano, J. Pérez; Álvarez, Ruth; Bruna, Jordi; Subirá, Dolores

doi:10.1016/j.trsl.2014.03.012

Cited by 6 publications

(6 citation statements)

References 25 publications

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“…In addition, the possibility of distinguishing between the cytologically tumor-negative and tumor-positive cases based on the cut-off macrophage ratio was demonstrated. Similar studies focusing on inflammatory cells have been reported by Djukic et al ( 7 ) and Illan et al ( 9 ). Djukic et al described the relation of total cell density (include tumor cells and leukocytes) and frequency of lymphocytes and granulocytes in the CFS, and lymphocytes and granulocytes were frequently observed in total cell number high cases (>4 cells/µl cases).…”

Section: Discussionsupporting

confidence: 85%

“…The frequency of specimens containing >1,000 cells was increased in malignant cases regardless of the tumor type. Regarding the cell count in CSF, several reports have indicated that an increased cell count is observed in the malignant CSF group via manual ( 4 , 6 , 7 ) and flow cytometric evaluation ( 9 ). In the present study, the number of cells on the glass slide did not reflect the number of cells per volume of CSF because the amount of CSF used varied between cases; however, the number of cells might have been increased in cytologically positive cases.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, leukocyte counting and typing are also performed using flow cytometry ( 9 ). For example, Illan et al ( 9 ) analyzed absolute cell count, tumor cell count, and inflammatory cell count in malignant lymphoma cases and leptomeningeal carcinomaosis ( 9 ). On the other hand, in terms of cytological specimens, the features of malignant cells are the main focus of CSF cytology.…”

Section: Introductionmentioning

confidence: 99%

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Macrophages in Giemsa-stained cerebrospinal fluid specimens predict carcinomatous meningitis

et al. 2020

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Carcinomatous meningitis is a condition in which tumor cells spread to the subarachnoid space. Leukocyte counting and typing of cerebrospinal fluid (CSF) cell components are performed manually or using flow cytometry. However, a detailed analysis of these variables using cytological specimens has not yet been reported. The present study analyzed cytological specimens using Giemsa staining and whole slide imaging with computer-assisted image analysis (CAIA) to clarify the characteristics of the leukocyte population in CSF, especially in carcinomatous meningitis. Manual evaluation was performed using 280 Giemsa-stained cytological CSF specimens. For 49 samples, CAIA was used for the whole area of Papanicolaou (Pap) staining, and Giemsa-stained specimens of the same samples were imaged using a virtual slide scanner. The nuclear morphology of the leukocytes was assessed, and the total leukocyte and leukocyte subset (lymphocytes, neutrophils and macrophages) counts were evaluated. Then, the number and percentage of each leukocyte subset population were evaluated. The total leukocyte count was significantly higher in Giemsa-stained specimens compared with in Pap-stained specimens. The percentage of macrophages was significantly higher in samples from patients with non-hematological tumors compared with in samples from patients without tumors, which was confirmed by manual evaluation of the specimens. In addition, the cut-off value of the percentage of macrophages that could discriminate between the tumor history negative cases and cytologically tumor positive cases was determined, revealing that a higher proportion of macrophages reflected the existence of atypical/malignant epithelial tumor cells in CSF samples. Thus, atypical cell screening and analysis of the background characteristics of the leukocyte population should be the focus of cytological specimen screening, especially not to miss carcinomatous meningitis.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Macrophages in Giemsa-stained cerebrospinal fluid specimens predict carcinomatous meningitis

et al. 2020

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“…In 1 study using flow cytometry immunophenotyping to describe the distribution of the main leukocyte populations in patients with neoplastic meningitis, solid tumor-related neoplastic meningitis showed prominent neutrophilic pleocytosis when compared with lymphoma-associated neoplastic meningitis. 36 A high CSF lymphocyte count can be seen within 24 hours of enteroviral infection. 37 Eosinophils increase when the following are present: parasitic and bacterial infestations (eg, Mycobacterium tuberculosis, Mycoplasma pneumoniae, Rickettsia rickettsii), hematological malignancies (acute lymphocytic leukemia, Hodgkin lymphoma), subarachnoid hemorrhage, and obstructive hydrocephalus.…”

Section: Laboratory Testsmentioning

confidence: 99%

Clinical Presentation, Diagnosis, and Radiological Findings of Neoplastic Meningitis

Rigakos¹,

Liakou²,

Felipe

et al. 2017

Cancer Control

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“…However, little is known about the tumor-associated population in LM [25, 26]. The long-held dogma of the lymphatic system absence in the CNS has been recently disproved.…”

Section: Discussionmentioning

confidence: 99%

Overexpression of syndecan-1, MUC-1, and putative stem cell markers in breast cancer leptomeningeal metastasis: a cerebrospinal fluid flow cytometry study

Cordone¹,

Masi²,

Summa³

et al. 2017

Breast Cancer Res

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BackgroundCancer is a mosaic of tumor cell subpopulations, where only a minority is responsible for disease recurrence and cancer invasiveness. We focused on one of the most aggressive circulating tumor cells (CTCs) which, from the primitive tumor, spreads to the central nervous system (CNS), evaluating the expression of prognostic and putative cancer stem cell markers in breast cancer (BC) leptomeningeal metastasis (LM).MethodsFlow cytometry immunophenotypic analysis of cerebrospinal fluid (CSF) samples (4.5 ml) was performed in 13 consecutive cases of BCLM. Syndecan-1 (CD138), MUC-1 (CD227) CD45, CD34, and the putative cancer stem cell markers CD15, CD24, CD44, and CD133 surface expression were evaluated on CSF floating tumor cells. The tumor-associated leukocyte population was also characterized.ResultsDespite a low absolute cell number (8 cell/μl, range 1–86), the flow cytometry characterization was successfully conducted in all the samples. Syndecan-1 and MUC-1 overexpression was documented on BC cells in all the samples analyzed; CD44, CD24, CD15, and CD133 in 77%, 75%, 70%, and 45% of cases, respectively. A strong syndecan-1 and MUC-1 expression was also documented by immunohistochemistry on primary breast cancer tissues, performed in four patients. The CSF tumor population was flanked by T lymphocytes, with a different immunophenotype between the CSF and peripheral blood samples (P ≤ 0.02).ConclusionsFlow cytometry can be successfully employed for solid tumor LM characterization even in CSF samples with low cell count. This in vivo study documents that CSF floating BC cells overexpress prognostic and putative cancer stem cell biomarkers related to tumor invasiveness, potentially representing a molecular target for circulating tumor cell detection and LM treatment monitoring, as well as a primary target for innovative treatment strategies. The T lymphocyte infiltration, documented in all CSF samples, suggests a possible involvement of the CNS lymphatic system in both lymphoid and cancer cell migration into and out of the meninges, supporting the extension of a new form of cellular immunotherapy to LM. Due to the small number of cases, validation on large cohorts of patients are warranted to confirm these findings and to evaluate the impact and value of these results for diagnosis and management of LM.Electronic supplementary materialThe online version of this article (doi:10.1186/s13058-017-0827-4) contains supplementary material, which is available to authorized users.

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Differences in cerebrospinal fluid inflammatory cell reaction of patients with leptomeningeal involvement by lymphoma and carcinoma

Cited by 6 publications

References 25 publications

Macrophages in Giemsa-stained cerebrospinal fluid specimens predict carcinomatous meningitis

Macrophages in Giemsa-stained cerebrospinal fluid specimens predict carcinomatous meningitis

Clinical Presentation, Diagnosis, and Radiological Findings of Neoplastic Meningitis

Overexpression of syndecan-1, MUC-1, and putative stem cell markers in breast cancer leptomeningeal metastasis: a cerebrospinal fluid flow cytometry study

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