Neoplastic meningitis laboratory tests
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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
- Carcinoembryonic antigen (CEA)
- Alpha-fetoprotein
- Beta-human chorionic gonadotropin
- Creatine-kinase BB isoenzyme
- β2 microglobulin
- Lactate dehydrogenase isoenzyme-5
- 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.
- CSF cytology (gold standard)
- Malignant cells, if present, are diagnostic
- CSF cytology is estimated to have >95% specificity for neoplastic meningitis
References
- ↑ 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.
- ↑ 2.0 2.1 2.2 Diagnosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016
- ↑ 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.