Leptomenigeal carcinomatosis - cauda equina

Case contributed by Frank Gaillard
Diagnosis certain

Lumbar spine

mri

The cauda equina demonstrates extensive leptomeningeal thickening and enhancement in keeping with leptomeningeal carcinomatosis. 

Case Discussion

The patient had a history of lung cancer and went on to have large volume CSF. 

Cytology

Cell block preparation of CSF

  1. Malignant cells present
  2. Strongly positive for pan-keratin on immunohistochemistry (and negative for CD20 and CD3)
  3. Diagnostic of metastatic non-small-cell carcinoma

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