Abstract
Background:We present a case with a history of gastric carcinoid in whom metastatic carcinoid cells were found in the cerebrospinal fluid 4 years after the resection of the stomach tumor. There are few reports describing the cytological features of carcinoid cells in the cerebrospinal fluid.
Case:The patient was a 76-year-old Japanese male. In September 1993, a primary gastric tumor, 2 cm in diameter, was resected and was diagnosed histologically as a carcinoid tumor without associated metastases. In April 1997, cerebrospinal fluid cytology revealed the tumor cells with scanty cytoplasm, clustered in a trabecular pattern. The nuclei were uniformly small, round or oval and smoothly outlined with fine, granular chromatin. At autopsy, there were no other metastatic tumors except in the brainstem, diencephalon and meninges. The histological and cytological findings of there tumors were similar to those of the resected primary tumor. Immunohistochemically, the tumor cells were positive for NSE and chromogranin A, and electron microscopy revealed that most cells contained the typical dense-core neurosecretory granules.
Conclusion: We report the finding of metastatic carcinoid cells in the cerebrospinal fluid of a case treated for gastric carcinoid. Immunohistochemistry and electron microscopy, as well as routine histopathology, are useful for the diagnosis of metastatic carcinoid in the brain.
