CNS cytopathology
CNS cytopathology is a subset of neuropathology and cytopathology.
An introduction to cytopathology is in the cytopathology article. Cerebrospinal (CSF) specimens are dealt with in a separate article called CSF cytopathology.
Basic approach
| CNS cytology | |||||||||||||||||||||||||||||||||||||||||
| Tumour | Non-tumour | ||||||||||||||||||||||||||||||||||||||||
| Glial | Non-glial | Infectious | Non-infectious | ||||||||||||||||||||||||||||||||||||||
| Glial | Non-glial | |
| Stranding (cytoplasmic) |
thin - cannot be seen at low power (2.5x obj.), true cytoplasmic processes |
thick - can be seen at low power (2.5x obj.), artifact of smearing |
| Edge of cluster | smooth/non-distinct | sharp |
Glial vs non-glial:
- Glial has ctyoplasmic processes/cytoplasmic strands (stringy processes) ~ 1 micrometer thick.
- They cannot be seen well at low power.
- Cotton candy-like appearance.
- Images:
Notes:
- Crush artifact (in smear preparation) can mimic glial processes.
- Crush artifact vs. real glial processes:
- No glial processes run perpendicular to the direction of smear.
- Glial processes may branch.
- Crushed/elongated nuclei are present in artifactual processes.
- Crush artifact vs. real glial processes:
Metastatic carcinoma
Main article: Metastasis
Things that don't smear well
Cohesive tumours:
- Meningioma.[3][4]
- Neurofibroma.[3]
- Schwannoma.[4]
- Subependymoma
- Abscess (because of fibrous capsule)
- Metastasis.[4]
Things that smear well
Dyscohesive tumours:
- Lymphoma.[4]
- Pituitary adenoma.[4]
- Oligodendroglioma.[4]
- Astrocytoma.
- Normal brain.
See also
References
- ↑ 1.0 1.1 URL: http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/sid117213.html. Accessed on: 2 November 2010.
- ↑ URL: http://moon.ouhsc.edu/kfung/JTY1/NeuroTest/Q92-Ans.htm. Accessed on: 3 November 2010.
- ↑ 3.0 3.1 Ironside JW (August 1994). "Update on central nervous system cytopathology. II. Brain smear technique". J. Clin. Pathol. 47 (8): 683–8. PMC 502135. PMID 7962615. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC502135/.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 Weedman Molavi, Diana (2008). The Practice of Surgical Pathology: A Beginner's Guide to the Diagnostic Process (1st ed.). Springer. pp. 252. ISBN 978-0387744858.