Neoplastic meningitis laboratory tests: Difference between revisions

Jump to navigation Jump to search
 
(15 intermediate revisions by 2 users not shown)
Line 4: Line 4:


==Overview==
==Overview==
The proposed algorithm for the diagnosis of neoplastic meningitis include the following:<ref name="BerzeroDiamanti2015">{{cite journal|last1=Berzero|first1=Giulia|last2=Diamanti|first2=Luca|last3=Di Stefano|first3=Anna Luisa|last4=Bini|first4=Paola|last5=Franciotta|first5=Diego|last6=Imarisio|first6=Ilaria|last7=Pedrazzoli|first7=Paolo|last8=Magrassi|first8=Lorenzo|last9=Morbini|first9=Patrizia|last10=Farina|first10=Lisa Maria|last11=Bastianello|first11=Stefano|last12=Ceroni|first12=Mauro|last13=Marchioni|first13=Enrico|title=Meningeal Melanomatosis: A Challenge for Timely Diagnosis|journal=BioMed Research International|volume=2015|year=2015|pages=1–6|issn=2314-6133|doi=10.1155/2015/948497}}</ref>
[[File:Dx.PNG|1200px|center]]


==Laboratory Findings==
==Laboratory Findings==
Laboratory findings consistent with the diagnosis of neoplastic meningitis include:<ref name=dxnm123>Diagnosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016</ref>
Laboratory findings consistent with the diagnosis of neoplastic meningitis include:<ref name="dxnm123">Diagnosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016</ref><ref name="AhnLim2013">{{cite journal|last1=Ahn|first1=Shin|last2=Lim|first2=Kyung Soo|title=Three Cases of Neoplastic Meningitis Initially Diagnosed with Infectious Meningitis in Emergency Department|journal=Case Reports in Emergency Medicine|volume=2013|year=2013|pages=1–4|issn=2090-648X|doi=10.1155/2013/561475}}</ref>


'''CSF analysis'''
'''CSF analysis'''
*Neoplastic meningitis is multifocal and cerebrospinal fluid at a particular site may show no abnormalities, if the pathological site is far away. Only 50% of those suspected with neoplastic meningitis are actually diagnosed and only the '''presence of malignant cells in the CSF''' is diagnostic.<ref name=dxnm123>Diagnosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016</ref>
*Neoplastic meningitis is multifocal and [[cerebrospinal fluid]] at a particular site may show no abnormalities, if the pathological site is far away. Only 50% of those suspected with neoplastic meningitis are actually diagnosed and only the '''presence of malignant cells in the CSF''' is diagnostic.<ref name="dxnm123">Diagnosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016</ref>
*The criteria for CSF abnormalities that are consistent with the diagnosis of neoplastic meningitis include:<ref name=dxnm123>Diagnosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016</ref>
*The criteria for CSF abnormalities that are consistent with the diagnosis of neoplastic meningitis include:<ref name="dxnm123">Diagnosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016</ref>
:*Increased opening pressure (> 200mm of H2O)
:*Increased opening pressure (> 200mm of H2O)
:*Increased Leukocytes (>4/mm3)
:*Increased Leukocytes (>4/mm3)
:*Elevated protein (>50 mg/dL)
:*Elevated protein (>50 mg/dL)
:*Decreased glucose (<60 mg/dL)
:*Decreased glucose (<60 mg/dL)
:*Tumor markers in CSF
:*Positive tumor markers in CSF
::*[[Carcinoembryonic antigen]] (CEA)
::*[[Carcinoembryonic antigen|Carcinoembryonic antigen (CEA)]]
::*[[Alpha-fetoprotein]]
::*[[Alpha-fetoprotein]]
::*[[Beta-human chorionic gonadotropin]]
::*[[Beta-human chorionic gonadotropin]]
::*[[creatine kinase|Creatine-kinase BB isoenzyme]]
::*[[creatine kinase|Creatine-kinase BB isoenzyme]]
::*[[Beta-2 microglobulin]]
::*[[Beta-2 microglobulin|β2 microglobulin]]
::*[[Lactate dehydrogenase|Lactate dehydrogenase isoenzyme-5]]
::*[[Lactate dehydrogenase|Lactate dehydrogenase isoenzyme-5]]
::*[[VEGF|Vascular endothelial growth factor]]
::*[[VEGF|Vascular endothelial growth factor]]
::*These markers can be good indirect indicators of n eoplastic meningitis, but most are not sensitive enough to improve cytological diagnosis.
:::*These markers can be good indirect indicators of n eoplastic meningitis, but most are not sensitive enough to improve cytological diagnosis.
:*CSF cytology ('''gold standard''')
::*Malignant cells, if present, are diagnostic
::*CSF cytology is estimated to have >95% specificity for neoplastic meningitis


==References==
==References==
Line 35: Line 42:
{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Neurology]]
[[Category:Neurosurgery]]

Latest revision as of 00:19, 28 August 2019

Neoplastic meningitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Neoplastic Meningitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

Staging

History and Symptoms

Physical Examination

Laboratory Findings

X-Ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Neoplastic meningitis laboratory tests On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Neoplastic meningitis laboratory tests

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Neoplastic meningitis laboratory tests

CDC on Neoplastic meningitis laboratory tests

Neoplastic meningitis laboratory tests in the news

Blogs on Neoplastic meningitis laboratory tests

Directions to Hospitals Treating Choroid plexus papilloma

Risk calculators and risk factors for Neoplastic meningitis laboratory tests

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

The proposed algorithm for the diagnosis of neoplastic meningitis include the following:[1]


Laboratory Findings

Laboratory findings consistent with the diagnosis of neoplastic meningitis include:[2][3]

CSF analysis

  • Neoplastic meningitis is multifocal and cerebrospinal fluid at a particular site may show no abnormalities, if the pathological site is far away. Only 50% of those suspected with neoplastic meningitis are actually diagnosed and only the presence of malignant cells in the CSF is diagnostic.[2]
  • The criteria for CSF abnormalities that are consistent with the diagnosis of neoplastic meningitis include:[2]
  • Increased opening pressure (> 200mm of H2O)
  • Increased Leukocytes (>4/mm3)
  • Elevated protein (>50 mg/dL)
  • Decreased glucose (<60 mg/dL)
  • Positive tumor markers in CSF
  • These markers can be good indirect indicators of n eoplastic meningitis, but most are not sensitive enough to improve cytological diagnosis.
  • CSF cytology (gold standard)
  • Malignant cells, if present, are diagnostic
  • CSF cytology is estimated to have >95% specificity for neoplastic meningitis

References

  1. Berzero, Giulia; Diamanti, Luca; Di Stefano, Anna Luisa; Bini, Paola; Franciotta, Diego; Imarisio, Ilaria; Pedrazzoli, Paolo; Magrassi, Lorenzo; Morbini, Patrizia; Farina, Lisa Maria; Bastianello, Stefano; Ceroni, Mauro; Marchioni, Enrico (2015). "Meningeal Melanomatosis: A Challenge for Timely Diagnosis". BioMed Research International. 2015: 1–6. doi:10.1155/2015/948497. ISSN 2314-6133.
  2. 2.0 2.1 2.2 Diagnosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016
  3. Ahn, Shin; Lim, Kyung Soo (2013). "Three Cases of Neoplastic Meningitis Initially Diagnosed with Infectious Meningitis in Emergency Department". Case Reports in Emergency Medicine. 2013: 1–4. doi:10.1155/2013/561475. ISSN 2090-648X.


Template:WikiDoc Sources