Brain metastases from systemic malignancies are the most common CNS neoplasms, which account for approximately 30% of clinically significant CNS tumors in adults and about 2% in children. In adults, up to 85% of cases arise from five organs: the lung, breast, skin (melanoma), kidney, and colon. Recent advances in the management of patients with CNS metastases have made accurate diagnosis of these tumors of paramount importance. In contrast to glial tumors, smears from metastatic carcinoma show cohesive clusters of hyperchromatic cells without cytoplasmic processes. On the other hand, the background may have blood and necrotic debris but is devoid of fibrillary structures. These features, often obscured in frozen sections, are nicely revealed in smears.
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