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- 头痛脑脊液检查
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Our fellow showed a case last week. I think it is interesting. Send here as a chinese new year gift for some ones interested.
about 50 y women with headach, CSF cytology exam. paitent has no previous malignant history.
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本帖最后由 于 2010-02-13 10:36:00 编辑
×参考诊断
最后诊断：恶性黑色素瘤，结合临床，可能原发于脑膜。
| 以下是引用掌心0164在2010-3-7 10:03:00的发言： 不会看脑积液，从细胞学基础知识看我首先考虑：感染性病变导致的反应性改变，需要排除一下血液系统的疾病，从目前的图片看好像恶性证据不足。 |
掌心0164,
Have seen you in the web for a long time. You must have had a good time for your new year.
需要排除一下血液系统的疾病: Blood tests were fine.
感染性病变导致的反应性改变: Are you sure?
What reactive cells can like the cells above?
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Most people think it is at least suspicious for malignancy. Patient had complete body exam and imaging study and did not find the lesion of other organs. Also blood work was normal. Clinicians asked pathologists if there was some way to help to make the final dx. There was no more CSF left. What is your suggestion?
If it is multiple choice question, which one will you pick?
The best interpretation of the CSF findings is:
A. Negative, reactive monocytes
B. Atypical cells present
C. Suspicious for malignancy
D. Positive for malignant cells, epithelial vs. non-epithelial malignancy
E. Positive for malignant cells, adenocarcinoma
