Diagnosing Primary Malignancy in Leptomeningeal Carcinomatosis by Using CSF Cytology and Immunohistochemistry: A Case Report

Abstract

We present a rare case of recurrent carcinoma of gallbladder with leptomeningeal carcinomatosis. Cerebrospinal fluid (CSF) cytology showed atypical cells, which were suspicious for malignancy on initial reporting. Diagnosis of malignancy and primary from hepatobiliary source was confirmed by doing immunohistochemistry on CSF cell block.

Keywords

Gallbladder carcinoma - immunohistochemistry - leptomeningeal

• References

• 1 Wistuba II, Gazdar AF. Gallbladder cancer: Lessons from a rare tumour. Nat Rev Cancer 2004; 4: 695-706
• 2 Mhatre SS, Nagrani RT, Budukh A, Chiplunkar S, Badwe R, Patil P. et al. Place of birth and risk of gallbladder cancer in India. Indian J Cancer 2016; 53: 304-8
• 3 Lobo L, Prasad K, Satoskar RR. Carcinoma of the gall bladder. J Clin Diagn Res 2012; 6: 692-5
• 4 Sons HU, Borchard F, Joel BS. Carcinoma of the gallbladder: Autopsy findings in 287 cases and review of the literature. J Surg Oncol 1985; 28: 199-206
• 5 Naylor AR, MacGregor JE, Hutcheon AW, Best PV. Meningeal carcinomatosis from a clinically undiagnosed signet ring cell primary in the gall bladder. Surg Neurol 1988; 29: 315-8
• 6 Miyagui T, Luchemback L, Teixeira GH, de Azevedo KM. Meningeal carcinomatosis as the initial manifestation of a gallbladder adenocarcinoma associated with a Krukenberg tumor. Rev Hosp Clin Fac Med Sao Paulo 2003; 58: 169-72
• 7 Hovestadt A, Henzen-Logmans SC, Vecht CJ. Immunohistochemical analysis of the cerebrospinal fluid for carcinomatous and lymphomatous leptomeningitis. Br J Cancer 1990; 62: 653-4
• 8 Gleissner B, Chamberlain MC. Neoplastic meningitis. Lancet Neurol 2006; 5: 443-52
• 9 Mack F, Baumert BG, Schäfer N, Hattingen E, Scheffler B, Herrlinger U. et al. Therapy of leptomeningeal metastasis in solid tumors. Cancer Treat Rev 2016; 43: 83-91
• 10 Grossman SA, Krabak MJ. “Leptomeningeal carcinomatosis. ” Cancer Treat Rev 1999; 25: 103-19
• 11 Kawamata T, Kawamura H, Kubo O, Sasahara A, Yamazato M, Hori T, Sarin YK. “Central nervous system metastasis from gallbladder carcinoma mimicking a meningioma. Case illustration.”. J Neurosur 1999; 91: 1059
• 12 Takano S, Yoshii Y, Owada T, Shirai S, Nose T. et al. ”Central nervous system metastasis from gallbladder carcinoma. Case report.”. Neurologia Medico-Chirurgica 1991; 31: 782-6
• 13 Randi G, Franceschi S, La Vecchia C. Gallbladder cancer worldwide: Geographical distribution and risk factors. Int J Cancer 2006; 118: 1591-602