TITLE:
Case report: Metastatic adenocarcinoma of the lung with filiform “ciliated” tumor cells in the cerebrospinal fluid
AUTHORS:
Daniel A. Zlotoff, Cynthia Kelly, Malca Kierson, Cindy McGrath, Prabodh Gupta
KEYWORDS:
Adenocarcinoma; Lung; Cilia; CSF
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.2 No.3,
June
5,
2013
ABSTRACT: Occurrence of cilia on the cell
surface is usually considered evidence of a non-neoplastic process. Rarely,
ciliated malignant tumors cells have been reported in pleural and ascitic
fluids from ovarian and endometrial adenocarcinomas, though not from the
cerebrospinal fluid (CSF) in association with pulmonary adenocarcinoma. We now
present a case report of a patient who initially presented with neurologic
symptoms. A CSF specimen revealed atypical cells with peripheral cilia and
some cytoplasmic pigment. Cytologic, morphologic, and immunohistochemical
analyses established this to be a metastatic adenocarcinoma of pulmonary origin
with metastases to the meninges, pelvis, and the vertebrae. Cilia are
generally the antithesis of malignancy as their presence is considered to be
evidence of proper regulation of the cell cycle within a well-differentiated
cell. This case offers the first described example of malignant ciliated cells
derived from a metastatic lung adenocarcinoma. An awareness of this unusual
presentation should aid in diagnosis and management when similar situations
are prospectively encountered.