Acta cytologica · 2025
Cerebrospinal Fluid Diagnosis in Pediatric Oncology: A Model of Cytopathological Classification.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Coelho Karina Munhoz de Paula Alves, Barbosa Camila, Junior Hercilio Fronza, Camilo Rosemary Aparecida, De Souza Balsimelli Ludmila Barbosa, Dzevieski Cindielly Ribeiro, Silva Bruna Louise, Condeixa de França Paulo Henrique, Roesler Rafael, Caldeira Xavier-Junior José Cândido
Аннотация
INTRODUCTION: Cytological evaluation of cerebrospinal fluid (CSF) is essential for the diagnosis and monitoring of pediatric neoplasms. However, its interpretation remains challenging, particularly due to the lack of a standardized classification system. The aim of this study was to review the institutional experience in the analysis of CSF samples from pediatric oncology patients and to propose a structured cytological classification model.
METHODS: This was a retrospective study analyzing 3,479 CSF samples from 466 patients aged 0-19 years. Samples were reclassified according to a six-category system based on morphological criteria (nondiagnostic, hemorrhagic, negative for malignancy, inflammatory/reactive, atypia of undetermined significance, positive for malignancy).
RESULTS: Most samples (89.2%) were classified as negative for malignancy. Samples positive for malignancy accounted for 2.6%, while 2.0% presented atypia of undetermined significance/suspicious for malignancy and 0.4% showed inflammatory or reactive changes. Hemorrhagic and nondiagnostic samples represented 5.6% and 0.2%, respectively. Acute lymphoblastic leukemia was the most frequent underlying diagnosis (46.6%).
CONCLUSION: This study proposes a practical CSF cytological classification model, based on the experience of a pathology laboratory specialized in pediatric oncology. The proposed standardization may contribute to enhance diagnostic consistency, improved clinicopathological correlation, and support the development of future guidelines in pediatric CSF cytopathology.
METHODS: This was a retrospective study analyzing 3,479 CSF samples from 466 patients aged 0-19 years. Samples were reclassified according to a six-category system based on morphological criteria (nondiagnostic, hemorrhagic, negative for malignancy, inflammatory/reactive, atypia of undetermined significance, positive for malignancy).
RESULTS: Most samples (89.2%) were classified as negative for malignancy. Samples positive for malignancy accounted for 2.6%, while 2.0% presented atypia of undetermined significance/suspicious for malignancy and 0.4% showed inflammatory or reactive changes. Hemorrhagic and nondiagnostic samples represented 5.6% and 0.2%, respectively. Acute lymphoblastic leukemia was the most frequent underlying diagnosis (46.6%).
CONCLUSION: This study proposes a practical CSF cytological classification model, based on the experience of a pathology laboratory specialized in pediatric oncology. The proposed standardization may contribute to enhance diagnostic consistency, improved clinicopathological correlation, and support the development of future guidelines in pediatric CSF cytopathology.