Cancer cells found in the cerebrospinal fluid more than 5 years after mastectomy for invasive lobular carcinoma of the breast

Abstract

Cytological examination of the cerebrospinal fluid (CSF) in a woman in her 70 s with a clinical diagnosis of right optic perineuritis showed loosely-cohesive clusters of small cells with round nuclei and mildly acidophilic cytoplasm. The abnormal cells were small in number in the first sample, but gradually increased in number in succeeding specimens. Incidentally obtaining the patient’s past history of left mastectomy for invasive lobular carcinoma 5 years 7 months earlier, we performed an immunohistochemical analysis of the cells at the fifth lumbar puncture specimen. It showed positive staining for estrogen receptor, GCDFP-15 and GATA-3 and negative staining for e-cadherin. Based on the findings, we made the final diagnosis of metastatic meningeal carcinomatosis from invasive lobular carcinoma of the left breast.