Teaching NeuroImages: Leptomeningeal lung carcinoma
Neurology current issue
A 55-year-old woman with lung cancer presented with leg numbness. Her systemic disease was well-controlled. MRI was precluded by a metallic cardiac device and spinal CT was unremarkable. On 2 occasions, examination of CSF demonstrated minimally elevated protein, but no abnormal cells. CT myelogram revealed bulky disease and CSF obtained a third time during the procedure confirmed the diagnosis (figure). To detect leptomeningeal carcinomatosis with 90%–98% sensitivity, 3 taps are needed. False-negatives can be minimized by withdrawal of 10.5 mL of CSF and immediate processing.1,2
Original Article: http://www.neurology.org/cgi/content/short/82/21/e183?rss=1
Júlio Pereira
www.neurocirurgiabr.com
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