術中迅速細胞診が有用であった毛様細胞性星細胞腫の１例

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  • A case of pilocytic astrocytoma and rapid intraoperative cytology usefulness

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Background: It is important to differentiate pilocytic astrocytoma, which is Grade I in the WHO classification, from Grade II astrocytoma. We report a case of pilocytic astrocytoma in which intraoperative rapid diagnosis by crush preparation cytology was useful.<BR>Case: The patient was a 12-year-old male in whom a cystic cerebellar tumor was discovered as an incidental finding on a CT image. Based on his age, the location of the cystic mass, progress, and the MRI findings, a preoperstive diagnosis of astrocytoma was made, and tumorectomy was carried out. Intraoperative rapid diagnosis by crush preparation cytology was performed.<BR>The nuclei of the tumor cells ranged from elliptic to spindleshaped. The cytoplasm of the tumor cells contained long glial fibers, thick sausage-like glial fibers that were indistinct in the HE-stained frozen specimen readily stained with orange G and were clearly observed in the vicinity. The thick sausage-like fibers appeared to be Rosenthal fibers, and we made a final diagnosis of pilocytic astrocytoma.<BR>Conclusion: Crush preparation cytology specimens are effective for detecting the Rosenthal fibers of pilocytic astrocytoma by rapid diagnosis. Such specimens enable differentiation between pilocytic astrocytoma and Grade II astrocytoma.

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