Pap stain: Medium power
Malignant cells with enlarged hyperchromatic nuclei and cytoplasmic vacuoles in a background of small lymphocytes and few histiocytes
Pap stain: High power
Malignant cells with high N:C ratios, enlarged hyperchromatic nuclei and prominent nucleoli in a background of small lymphocytes
Pap stain: High power
Malignant cells in small cluster with glandular features
Pap stain: High power
Single malignant cell with enlarged hyperchromatic nuclei and prominent nucleoli
Features
• Top three metastatic malignancies involving CSF
- Lung
- Breast
- Melanoma
• Multiple samples or immunocytochemistry may be needed to confirm disease
• Cellularity varies
• Often form small clusters
• Single cells usually stand out since they are larger in comparison to lymphocytes
• Usually high N:C ratio
• Cytoplasm may have mucin vacuoles
• Nuclei enlarged and hyperchromatic
• Irregular nuclear membranes
• May have intranuclear cytoplasmic inclusions