The Experts below are selected from a list of 261 Experts worldwide ranked by ideXlab platform
Marc C Chamberlain - One of the best experts on this subject based on the ideXlab platform.
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Choroid Plexus Tumors
The Choroid Plexus and Cerebrospinal Fluid, 2016Co-Authors: Sean Grimm, Marc C ChamberlainAbstract:Abstract Rarely, the choroid plexus (CP) is the site of primary or secondary tumors. Patients present with symptoms of increased intracranial pressure from obstructive hydrocephalus. Because of the risk of leptomeningeal metastases, staging consists of complete spinal axis imaging and Cerebrospinal Fluid Cytology. Choroid plexus papilloma (CPP, WHO grade I) and choroid plexus carcinoma (CPC, WHO grade III) are primary choroid plexus tumors (CPTs) that occur predominantly in children. Maximal surgical resection is the initial treatment for both tumors. After surgery, CPPs can be followed while CPCs should be treated with adjuvant chemotherapy or radiotherapy. With treatment, CPP and CPC are associated with 5-year survivals of 97 and 35%, respectively. Mutation of the TP53 gene correlates with poor outcome in CPC; wild type and mutated TP53 have 5-year survival of 82 and 0%, respectively. In adults, secondary CPTs predominate over primary tumors. CP metastases occur in approximately 2.6% of cancer patients.
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neoplastic meningitis survival as a function of Cerebrospinal Fluid Cytology
Cancer, 2009Co-Authors: Marc C Chamberlain, Sandra K JohnstonAbstract:BACKGROUND: This retrospective comparison evaluated survival in 2 well-matched cohorts of patients with neoplastic meningitis (NM) presenting with or without positive Cerebrospinal Fluid (CSF) Cytology. METHODS: Two patient cohorts were studied: 42 individuals with (Group A) and 42 without (Group B) positive CSF Cytology. Groups were matched with respect to age; primary tumor; Karnofsky performance status; site of NM disease (cranial nerves or spinal cord); treatment (radiotherapy and chemotherapy; systemic and intraventricular); and absence of CSF compartmentalization, NM-related encephalopathy, and neuroradiographic bulky central nervous system disease. Primary tumor histology included breast (28 patients), non-Hodgkin lymphoma (14 patients), nonsmall cell lung cancer (14 patients), melanoma (12 patients), and others (16 patients). NM at presentation revealed cranial neuropathy (40 patients) or spinal cord dysfunction (58 patients). Radiotherapy was administered to 69 patients (whole brain only in 14 patients [7 each in Groups A and B], restricted spine only in 51 patients [25 in Group A and 26 in Group B], and both whole brain and restricted spine in 4 patients [2 each in Groups A and B]). All patients received intraventricular chemotherapy and 60 (30 each in Groups A and B) received concurrent tumor-specific systemic chemotherapy. RESULTS: The median, 3-month, 6-month, and 12-month survival rates for patients with NM were not significantly different between those patients with positive CSF Cytology (18 weeks, 83%, 33%, and 9.5%, respectively) and those without positive CSF Cytology (20 weeks, 90.5%, 40.5%, and 9.5%, respectively). All patients demonstrated progressive disease and died of either NM or systemic cancer. CONCLUSIONS: In patients with NM who were matched for known prognostic variables, the presence or absence of CSF Cytology did not appear to influence survival.
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Ependymomas
Current Neurology and Neuroscience Reports, 2003Co-Authors: Marc C ChamberlainAbstract:Ependymomas are uncommon neoplasms of the central nervous system (CNS), and as a consequence, few randomized, clinical trials have been performed, thereby limiting treatment guidelines. A review of the literature would permit the following conclusions regarding treatment. The best management of newly diagnosed ependymoma entails a complete resection corroborated by postoperative contrast-enhanced magnetic resonance imaging (MRI). If an incomplete resection is documented, a second attempt at gross total resection should be considered, given the prognostic significance of complete resection. Small volume residual disease is best managed with involved-field radiotherapy unless postoperative staging (Cerebrospinal Fluid Cytology, neuraxis MRI) documents metastatic disease, which is best managed by craniospinal irradiation. The role of chemotherapy is uncertain and in general would be reserved for patients having previously failed surgery and radiotherapy. Disease-free survival following recurrence is unusual (
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a comparison between ventricular and lumbar Cerebrospinal Fluid Cytology in adult patients with leptomeningeal metastases
Neuro-oncology, 2001Co-Authors: Marc C Chamberlain, Patty A Kormanik, Michael GlantzAbstract:Leptomeningeal metastases (LMs) are common metastatic complications, occurring in at least 5% of patients with disseminated cancer. Cerebrospinal Fluid (CSF) Cytology remains the standard for diagnosis and assessment of treatment response, but may be inadequate. Our objective was to compare ventricular and lumbar CSF Cytology in patients who had cytologically proven LM and were receiving intra-CSF chemotherapy. Sixty patients with LM, positive lumbar CSF Cytology documented at diagnosis, limited extent of CNS disease, and no evidence of CSF flow obstruction were treated with a variety of intra-CSF chemotherapies. All patients underwent a single simultaneous ventricular and lumbar CSF sampling (mean volume of CSF per site examined, 10 ml) to assess response to therapy at either 1 or 2 months after treatment initiation. Ventricular CSF Cytology was positive in 44 patients (73%), 35 of whom were also positive by lumbar CSF Cytology. Lumbar CSF Cytology was positive in 45 patients (75%), of which 35 were also positive by ventricular CSF Cytology. Samples were negative at both ventricular and lumbar sites in 6 patients (10%). Paired CSF cytologies were discordant in 19 (32%) patients. The lumbar Cytology was negative in 9, whereas the ventricular Cytology was positive (lumbar false-negative rate of 17%); the ventricular Cytology was negative in 10, whereas the lumbar Cytology was positive (ventricular false-negative rate of 20%). In the presence of spinal signs or symptoms of LM, the lumbar CSF Cytology was more likely to be positive than was the ventricular (odds ratio = 2.86; 95% confidence interval, 0.86-9.56). Conversely, in the presence of cranial signs or symptoms, the ventricular CSF Cytology was more likely to be positive than was the lumbar (odds ratio = 2.71; 95% confidence interval, 0.76-9.71). In this cohort of patients, whose LM was documented initially by positive lumbar CSF Cytology, ventricular and lumbar CSF samples obtained during treatment had similar false-negative rates, depending on the site of clinical or radiologic disease. This suggests that both lumbar and ventricular sites must be sampled when assessing treatment response. If clinical or radiographic disease is present only at 1 site, then CSF from that site is more likely to be positive than is CSF obtained from the more distant site.
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quantitative Cerebrospinal Fluid Cytology in patients receiving intracavitary chemotherapy
Annals of Neurology, 1993Co-Authors: Valentina Russack, Marc C ChamberlainAbstract:Cytological evaluation of Cerebrospinal Fluid (CSF) is an important means of following response to intracavitary chemotherapy for leptomeningeal malignancy. We studied the feasibility of quantitative cytological evaluation by retrospective analysis of serial CSF specimens from 7 patients receiving phase I intracavitary chemotherapy for leptomeningeal malignancy who had persistent malignant Cytology. Three to 34 CSF specimens per patient obtained over a 3- to 48-week period were reviewed. Significant (five- to 10-fold or greater) reductions in numbers of malignant cells in CSF during treatment could be identified in specimens otherwise diagnosed as positive. Quantitative CSF cytological evaluation is neither overly time consuming nor tedious to perform and may provide useful clinical information.
Guojun Zhang - One of the best experts on this subject based on the ideXlab platform.
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diagnosis of central nervous system lymphoma via Cerebrospinal Fluid Cytology a case report
BMC Neurology, 2019Co-Authors: Hui Zhao, Limin Zhang, Guanghui Zheng, Hong Lv, Xiao Li, Bei Song, Guojun ZhangAbstract:Primary central nervous system lymphoma (PCNSL) is the most prevalent brain, spinal cord, eyes, and leptomeningeal lymphoma. It is often misdiagnosed due to an unspecific presentation or unavailable biopsy and results in a poor prognosis. Although the craniocerebral imaging examination of PCNSL has some characteristics, it is limited, and atypical cases are especially difficult to identify with intracranial tumours and other diseases. The biopsy, as the gold standard for PCNSL diagnosis, is not eligible for all patients suspected of having PCNSL. This report documents a woman who presented with a three-month history of numbness and weakness in the right leg. She was treated with drugs at a local hospital for one month. She developed demyelination lesions and her symptoms were aggravated. The patient was admitted to the Department of Nerve Infection and Immunology at Tiantan Hospital. Head magnetic resonance imaging (MRI) enhanced scanning indicated significant inflammatory demyelinating disease, and lymphoma was not excluded. CSF revealed a high protein level and CSF Cytology detected abnormal cells, PCNSL was eventually presumed according to positive CSF Cytology and cytological detection of the Cerebrospinal Fluid flow. PCNSL is a highly invasive tumour. With the development of technologies such as Cerebrospinal Fluid Cytology and flow Cytology, CSF analysis has become one of the definite diagnosis methods, and the tumour cell finding in CSF is the only reliable basis for diagnosis. Flow cytometric analysis and gene rearrangement testing also provide objective evidence.
Ch J Vecht - One of the best experts on this subject based on the ideXlab platform.
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the diagnostic accuracy of magnetic resonance imaging and Cerebrospinal Fluid Cytology in leptomeningeal metastasis
Journal of Neurology, 1999Co-Authors: C S M Straathof, Hein G De Bruin, Diederik W J Dippel, Ch J VechtAbstract:Diagnostic decision making in the case of patients suspected of having leptomeningeal metastasis (LM) can be very difficult. The results of Cerebrospinal Fluid (CSF) Cytology can be repeatedly negative, and the predictive value of gadolinium-enhanced magnetic resonance imaging (MRI) is not well known. We report the results of CSF Cytology and Gd MRI in 61 patients with known cancer, suspected of having LM. We combined our data with those from a similar study and calculated the sensitivity and specificity of CSF and Gd MRI, in the absence of a “gold standard diagnosis.” CSF Cytology was positive for LM in 35 patients and MRI in 38. With CSF Cytology sensitivity 75% and specificity 100%, with Gd MRI sensitivity was 76% but specificity only 77%. We conclude that Gd MRI provides strong support in the diagnosis of LM in patients with cancer who have negative results on CSF Cytology.
G Jacobi - One of the best experts on this subject based on the ideXlab platform.
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lyme borreliosis mimicking central nervous system malignancy the diagnostic pitfall of Cerebrospinal Fluid Cytology
Brain & Development, 2000Co-Authors: M Kieslich, A Fiedler, Pablo Hernaiz Driever, Roger Weis, D Schwabe, G JacobiAbstract:We report two children with acute loss of neurological functions and signs of an increased intracranial pressure. Imaging techniques ruled out space occupying lesions, whereas CSF Cytology indicated CNS involvement of a non-Hodgkin lymphoma in the form of abnormal lymphocytic pleocytosis with malignancy criteria fulfilling lymphoid cells. CSF protein electrophoresis and Borrelia burgdorferi serology revealed neuroborreliosis which was successfully treated with antibiotic therapy. The malignancy mimicking Cytology is based on a blastoid transformation of B- and T-lymphocytes due to the antigenic stimulus of B. burgdorferi infection. Lymphoid cells in the CSF of a patient with acute or chronic neurological symptoms raise the differential diagnosis of inflammatory etiology versus CNS lymphoma. Monomorphism and higher quantity of the lymphoid cells point to CNS lymphoma. A lower quantity and polyclonal pattern of lymphoid cells associated with an elevated protein fraction caused by intrathecal immunoglobulin synthesis suggest an inflammatory etiology.
Hui Zhao - One of the best experts on this subject based on the ideXlab platform.
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diagnosis of central nervous system lymphoma via Cerebrospinal Fluid Cytology a case report
BMC Neurology, 2019Co-Authors: Hui Zhao, Limin Zhang, Guanghui Zheng, Hong Lv, Xiao Li, Bei Song, Guojun ZhangAbstract:Primary central nervous system lymphoma (PCNSL) is the most prevalent brain, spinal cord, eyes, and leptomeningeal lymphoma. It is often misdiagnosed due to an unspecific presentation or unavailable biopsy and results in a poor prognosis. Although the craniocerebral imaging examination of PCNSL has some characteristics, it is limited, and atypical cases are especially difficult to identify with intracranial tumours and other diseases. The biopsy, as the gold standard for PCNSL diagnosis, is not eligible for all patients suspected of having PCNSL. This report documents a woman who presented with a three-month history of numbness and weakness in the right leg. She was treated with drugs at a local hospital for one month. She developed demyelination lesions and her symptoms were aggravated. The patient was admitted to the Department of Nerve Infection and Immunology at Tiantan Hospital. Head magnetic resonance imaging (MRI) enhanced scanning indicated significant inflammatory demyelinating disease, and lymphoma was not excluded. CSF revealed a high protein level and CSF Cytology detected abnormal cells, PCNSL was eventually presumed according to positive CSF Cytology and cytological detection of the Cerebrospinal Fluid flow. PCNSL is a highly invasive tumour. With the development of technologies such as Cerebrospinal Fluid Cytology and flow Cytology, CSF analysis has become one of the definite diagnosis methods, and the tumour cell finding in CSF is the only reliable basis for diagnosis. Flow cytometric analysis and gene rearrangement testing also provide objective evidence.