Metastização Leptomeníngea de Origem Ginecológica
O Papel Decisivo da Citologia
DOI:
https://doi.org/10.26537/citotech.vi9.6906Palavras-chave:
Líquido Cefalorraquidiano, Carcinoma Adenoescamoso Endocervical, Leptomeningite Carcinomatosa, Imunocitoquímica, Vírus do Papiloma HumanoResumo
O exame citopatológico do líquido cefalorraquidiano é um método diagnóstico essencial na avaliação de patologias do sistema nervoso central, sendo fundamental na deteção de disseminação meníngea por neoplasias.
O presente caso de estudo refere-se a uma mulher de 34 anos previamente diagnosticada com carcinoma adenoescamoso do colo do útero associado ao vírus do papiloma humano de alto risco, com metastização ganglionar confirmada. Cerca de um ano após histerectomia radical, perante sintomatologia neurológica, foi equacionada a hipótese de leptomeningite carcinomatosa.
A análise citológica do líquido cefalorraquidiano revelou a existência de células malignas de morfologia epitelial, confirmada por imunocitoquímica, com imunomarcação positiva para a pan-citoqueratina MNF116, a proteína p16 e negativa para CD20. A história oncológica prévia e a morfologia celular, complementada pela avaliação de biomarcadores por testes de imunocitoquímica, permitiram o diagnóstico de metastização leptomeníngea de carcinoma do colo do útero.
Este caso evidencia a relevância do exame citológico do líquido cefalorraquidiano que, associado a técnicas complementares, permitiu o diagnóstico de metástases meníngeas de neoplasia de origem ginecológica, entidade rara mas clinicamente relevante.
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