Abstract
BackgroundAs extra-cranial metastasis of glioblastoma multiforme (GBM) is rare, it may create a diagnostic dilemma especially during interpretation of fine needle aspiration biopsy (FNAB) cytology.Case presentationWe present transbronchial FNAB findings in a 62-year-old smoker with lung mass clinically suspicious for a lung primary. The smears of transbronchial FNAB showed groups of cells with ill-defined cell margins and cytological features overlapping with poorly differentiated non-small cell carcinoma. The tumor cells demonstrated lack of immunoreactivity for cytokeratin, thyroid transcription factor-1, and usual neuroendocrine markers, synaptophysin and chromogranin in formalin-fixed cellblock sections. However, they were immunoreactive for the other neuroendocrine immunomarker, CD56, suggesting neural nature of the cells. Further scrutiny of clinical details revealed a history of GBM, 13 months status-post surgical excision with radiation therapy and systemic chemotherapy. The tumor recurred 7 months earlier and was debulked surgically and with intra-cranial chemotherapy. Additional evaluation of tumor cells for glial fibrillary acidic protein (GFAP) immunoreactivity with clinical details resulted in final interpretation of metastatic GBM.ConclusionLack of clinical history and immunophenotyping may lead to a diagnostic pitfall with possible misinterpretation of metastatic GBM as poorly differentiated non-small cell carcinoma of lung in a smoker.
Highlights
As extra-cranial metastasis of glioblastoma multiforme (GBM) is rare, it may create a diagnostic dilemma especially during interpretation of fine needle aspiration biopsy (FNAB) cytology.Case presentation: We present transbronchial FNAB findings in a 62-year-old smoker with lung mass clinically suspicious for a lung primary
We report a case in which optimum clinical history and immunohistochemical evaluation played a crucial role in preventing a diagnostic pitfall of misinterpreting FNAB cytology of lung mass in a smoker
Cytomorphological features on adequacy evaluation of transbronchial FNAB smears of the right upper lobe of lung (RUL) mass were consistent with poorly differentiated non-small cell tumor
Summary
As extra-cranial metastasis of glioblastoma multiforme (GBM) is rare, it may create a diagnostic dilemma especially during interpretation of fine needle aspiration biopsy (FNAB) cytology.Case presentation: We present transbronchial FNAB findings in a 62-year-old smoker with lung mass clinically suspicious for a lung primary. A literature search revealed only a few case reports of extra-cranial metastasis of primary GBM to various organs such as spleen [5], skin [8], heart [7], bone [6], cervical lymph nodes [9,11] and lung [10,12-14]. In all these cases the metastases occurred after the resection of primary intra-cranial tumor with an average time interval of 10 months. We report a case in which optimum clinical history and immunohistochemical evaluation played a crucial role in preventing a diagnostic pitfall of misinterpreting FNAB cytology of lung mass in a smoker
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
