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id="par0005" class="elsevierStylePara elsevierViewall">57-year-old male diagnosed with glioblastoma treated with partial resection, adjuvant radiotherapy and temozolomide. Patient consulted for episodes of speech arrest lasting a few minutes and episodes of time-space disorientation of up to 30<span class="elsevierStyleHsp" style=""></span>min. There were clinical signs and symptoms of bilateral papilledema. Laboratory tests were normal. Brain MRI showed signs of hydrocephalus, without neoplastic disease progression. The electroencephalogram (EEG) showed interictal spikes in the left cerebral hemisphere and the EEG during disorientation showed diffuse slowing. Examination of the cerebrospinal fluid (CSF) revealed hypoglycorrhachia and hyperproteinorrhachia (elevated protein levels). Cytological analysis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B. May Grünwald-Giemsa staining) showed large cells with rounded and eccentric nucleus, with immature chromatin and presence of nucleoli, with extensive cytoplasm and basophil, associated with multiple cytoplasmic protrusions. Immunohistochemistry (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C) was positive for glial fibrillary acidic protein indicative of leptomeningeal gliomatosis. Due to the clinical condition of the patient, active cancer treatment was discarded, and is currently under palliative treatment. The prognosis for these patients is ominous. Typically, a meningeal biopsy is necessary, since the cytological study of CSF rarely confirms the diagnosis. The treatment is based on craniospinal irradiation, intrathecal and systemic chemotherapy and sometimes the derivation of CSF for associated hydrocephalus.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Rodríguez-Lobato LG, Gómez-Galván JB, Martínez Hernández D, Rozman M. Gliomatosis leptomeníngea. Med Clin (Barc). 2016;147:279.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 835 "Ancho" => 1082 "Tamanyo" => 87756 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014700000006/v1_201612070134/S2387020616306003/v1_201612070134/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014700000006/v1_201612070134/S2387020616306003/v1_201612070134/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020616306003?idApp=UINPBA00004N" ]
Journal Information
Vol. 147. Issue 6.
Pages 279 (September 2016)
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Vol. 147. Issue 6.
Pages 279 (September 2016)
Image in medicine
Leptomeningeal gliomatosis
Gliomatosis leptomeníngea
Luis Gerardo Rodríguez-Lobatoa,
, Juan Bernardo Gómez-Galvánb, Daniel Martínez Hernándezc, María Rozmand
Corresponding author
a Departamento de Hematología, Instituto Clínic de Enfermedades Hematológicas y Oncológicas, Hospital Clínic, Universidad de Barcelona, Barcelona, Spain
b Departamento de Neurología, Instituto Clínic de Neurología, Hospital Clínic, Universidad de Barcelona, Barcelona, Spain
c Departamento de Patología, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, Spain
d Unidad de Hematopatología, Departamento de Patología, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, Spain
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