Mollaret's meningitis: Case report with immunocytochemical and polymerase chain reaction amplification studies

Teot, Lisa A.; Sexton, Carol W.

doi:10.1002/(sici)1097-0339(199611)15:4<345::aid-dc19>3.0.co;2-o

Cited by 18 publications

(6 citation statements)

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“…When Mollaret first described this entity in 1944, these mononuclear cells were thought to be endothelial in origin. 2 Since then, electron microscopy 13 and immunohistochemistry 14,15 have confirmed this cell to be a monocyte. While these monocytoid cells are distinctive, they are not specific for MM.…”

Section: Mollaret's Meningitismentioning

confidence: 95%

“…1,3 The monocytes in MM have bean-shaped bilobed nuclei as well as nuclei with deep nuclear clefts with the so-called "footprint" appearance. 11,15 Other features include multiple blunt-ended cytoplasmic pseudopods and degenerated cellular forms or "ghost cells." 11,12 In our series, monocytic pleocytosis was present in more than 90% of cases.…”

Section: Mollaret's Meningitismentioning

confidence: 99%

“…In 1944, Mollaret originally described the mononuclear cells as endothelial in origin. 2 However, subsequent studies by Mollaret and others, using electron microscopy 12,13 and immunohistochemistry, 14,15 have confirmed that the Mollaret cell is monocytic in origin. Only a limited number of cases have been described in the cytopathologic literature on this subject.…”

mentioning

confidence: 95%

“…Only a limited number of cases have been described in the cytopathologic literature on this subject. 11,12,15 The present study summarizes our experience at The Johns Hopkins Hospital with 18 cases of MM from 14 patients. The study elaborates the cytomorphologic features of MM and highlights the importance of clinical correlation to exclude other conditions that may present with similar clinical and/or cytomorphologic findings.…”

mentioning

confidence: 96%

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Mollaret's meningitis: Cytopathologic analysis of fourteen cases

Chan

Parwani

Levi

et al. 2003

Diagnostic Cytopathology

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Mollaret's meningitis (MM) is a rare disease of benign nature characterized by recurrent episodes of aseptic meningitis. Cerebrospinal fluid (CSF) examination remains the sole diagnostic modality. Eighteen CSF samples from 14 patients were studied along with the clinical data. Specimens were prepared by cytocentrifugation and Millipore filtration and were stained with Diff-Quik and Papanicolaou stains. Eight patients were men and six were women, with an age range of 17-74 yr (mean age 37 yr). Most common clinical presentation was recurrent episodes of headaches and photophobia followed by a sustained mild fever lasting 5-7 days. The CSF showed markedly increased cellularity with pleocytosis. The differential count showed predominant monocytosis ranging from 84% to 100% (mean 96). In our series, two patients had herpes simplex virus type 2 (HSV-2) DNA detected by polymerase chain reaction (PCR) in the CSF. The monocytes were seen predominantly singly, but three cases showed a strong tendency to aggregate in small groups. Phenotypically, these cells had bean-shaped bilobed nuclei as well as multiple deep nuclear clefts depicting the so-called "footprint" appearance. In four cases, multiple blunt-tipped cytoplasmic pseudopods were noted. Degenerated monocytes with the appearance of the so-called "ghost cells" were noted in one-half of the cases. Background cells were mostly small mature lymphocytes; however, one-half of cases showed a significant amount of plasma cells and/or polymorphonuclear leukocytes (PMNs). Lysed blood with hemosiderin-laden macrophages and numerous leptomeningeal cells were seen in two cases. CSF examination of MM presents a spectrum of cytomorphologic features. When interpreted in light of the appropriate clinical setting. the latter, although nonspecific, provides an accurate diagnosis. The differential diagnosis includes various degenerative, inflammatory/infectious, and lymphoproliferative disorders of the central nervous system.

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Section: Mollaret's Meningitismentioning

confidence: 95%

Section: Mollaret's Meningitismentioning

confidence: 99%

mentioning

confidence: 95%

mentioning

confidence: 96%

See 2 more Smart Citations

Mollaret's meningitis: Cytopathologic analysis of fourteen cases

Chan

Parwani

Levi

et al. 2003

Diagnostic Cytopathology

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“…Numerous attempts to establish a microbiological cause for Mollaret's meningitis have failed, although herpes simplex virus (HSV) has been isolated from CSF in some cases [6]. To date, the pathogenesis of this entity remains uncertain, although an association with HSV has been reported in rare cases [7]. Bergstrom [8], Berger [1], Picard et al [9], and Jensenius et al [10] reported Mollaret's meningitis caused by HSV type 2.…”

mentioning

confidence: 99%