Serial lumbar and ventricle cerebrospinal fluid lactate dehydrogenase activities in patients with leptomeningeal metastases from solid and haematological tumours.

Twijnstra, A.; Zanten, Anton P. van; Hart, A. A. M.; Visser, B.W. Ongerboer de

doi:10.1136/jnnp.50.3.313

Cited by 39 publications

(17 citation statements)

References 34 publications

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“…The CSF carcinoembryonic antigen (CEA) level is elevated in some cases of breast carcinoma metastatic to the leptomeninges, but must be compared with the serum CEA level because CEA can cross the blood-brain barrier. Elevated CEA levels in CSF may be a result of elevated serum CEA levels [69]. Neuroimaging is necessary to help diagnose and define the extent of disease, which may be as low as the cauda equina (Fig.…”

Section: Manifestations Of Cns Metastases Other Than Brain Lmmentioning

confidence: 99%

Diagnosis and Management of Central Nervous System Metastases from Breast Cancer

Chang

2003

The Oncologist

146

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The brain, cranial nerves, leptomeninges, spinal cord, and eye compose the central nervous system (CNS) and are at risk for the development of metastases from breast cancer. Such metastases are diagnosed on the basis of clinical suspicion and substantiated by neuroimaging, resection when indicated, and sampling of cerebrospinal fluid when leptomeningeal metastasis (LM) is suspected. Treatment is aimed at palliation of symptoms and preservation of neurologic function. Historically, conventional radiation therapy has been the mainstay of palliative treatment for brain, cranial nerve, spinal cord, and ocular metastases. However, additional treatment options for brain metastases have been brought about by technological advances in surgery to resect brain metastases, and stereotactic radiosurgery (SRS) to focally irradiate metastases, both of which have been substantiated by data from randomized trials. Ongoing research is aimed at refining criteria to select which patients with brain metastases should undergo surgery and SRS and how these focal therapies should be optimally integrated with whole-brain radiotherapy. Therapy for LM must carefully balance the potential risks and perceived benefits associated with CNS-directed therapies. Despite advances in neuroimaging, surgery, and radiation therapy, novel treatments are needed to improve the effectiveness of treatments for CNS metastases, especially LM, while reducing attendant neurotoxicity.

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Section: Manifestations Of Cns Metastases Other Than Brain Lmmentioning

confidence: 99%

Diagnosis and Management of Central Nervous System Metastases from Breast Cancer

Chang

2003

The Oncologist

146

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“…Particular tumor markers such as carcinoembryonic antigen (CEA) from adenocarcinomas and ␣-fetoprotein and ␤-human chorionic gonadotropin from testicular cancers and primary extragonadal CNS tumors can be relatively specific for NM when elevated in CSF in the absence of markedly elevated serum levels [16,26]. Nonspecific tumor markers such as creatine-kinase BB isoenzyme, tissue polypeptide antigen, ␤ 2 -microglobulin, ␤-glucoronidase, lactate dehydrogenase isoenzyme-5, and more recently vascular endothelial growth factor can be strong indirect indicators of NM, but none are sensitive enough to improve the cytological diagnosis [27][28][29][30][31]. The use of these biochemical markers can be helpful as adjunctive diagnostic tests and, when followed serially, to assess response to treatment.…”

Section: Csf Examinationmentioning

confidence: 99%

Neoplastic Meningitis

2008

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After completing this course, the reader should be able to:1. Describe the epidemiology of leptomeningeal metastasis.2. Participate in the diagnosis of leptomeningeal metastasis. Engage in the treatment of leptomeningeal metastasis.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTBackground: Neoplastic meningitis (NM) is a common problem in neuro-oncology, occurring in approximately 5% of all patients with cancer.Methods: Notwithstanding frequent focal signs and symptoms, NM is a disease affecting the entire neuraxis, and therefore staging and treatment need encompass all cerebrospinal fluid (CSF) compartments.Results: Central nervous system staging of NM includes contrast-enhanced cranial computerized tomography or magnetic resonance imaging (MR-Gd), contrast-enhanced spine magnetic resonance imaging or computerized tomographic myelography and radionuclide CSF flow study. Treatment of NM incorporates involved-field radiotherapy of bulky or

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“…Various ‘non-routine’ CSF disease markers have been evaluated, and often a postmortem study design was used [2, 3]. A previous retrospective study showed a more homogeneous distribution of lactate in the CSF compared to leukocytes and protein [4].…”

Section: Introductionmentioning

confidence: 99%

Does Lumbar Cerebrospinal Fluid Reflect Ventricular Cerebrospinal Fluid? A Prospective Study in Patients with External Ventricular Drainage

et al. 2002

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Ventriculitis may sometimes occur after an external ventricular drain has been removed, and diagnosis has to be made by lumbar puncture. But are the lumbar findings comparable to previously obtained ventricular results? In a prospective study, sample pairs of ventricular and lumbar cerebrospinal fluid (CSF) were obtained at an interval of <30 min in 25 patients with increased intracranial pressure suffering from cerebral hemorrhage (n = 15), meningitis/encephalitis (n = 6), cerebral infarction (n = 3), and meningeosis carcinomatosa (n = 1). CSF was analyzed for protein, albumin, IgG, IgA, IgM, glucose, lactate, and leukocytes including cytological differentiation. A significant ventriculo-lumbar increase was observed for protein, albumin, and the immunoglobulins. Lactate was distributed equally in ventricular and lumbar CSF, as well as glucose in the cerebral hemorrhage subgroup (n = 15). Cell count failed to show a clear ventriculo-lumbar ratio. Cytological distribution was comparable in lumbar and ventricular CSF, except for macrophages showing a significant rostrocaudal decrease. In conclusion, in cases of clinically suspected bacterial central nervous system infection after removal of an external ventricular drain, lumbar CSF lactate, glucose, and cytology are comparable to previously determined ventricular values, and thus may help physicians to choose the best treatment.

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Serial lumbar and ventricle cerebrospinal fluid lactate dehydrogenase activities in patients with leptomeningeal metastases from solid and haematological tumours.

Cited by 39 publications

References 34 publications

Diagnosis and Management of Central Nervous System Metastases from Breast Cancer

Diagnosis and Management of Central Nervous System Metastases from Breast Cancer

Neoplastic Meningitis

Does Lumbar Cerebrospinal Fluid Reflect Ventricular Cerebrospinal Fluid? A Prospective Study in Patients with External Ventricular Drainage

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