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Leptomeningeal Neoplasia: Epidemiology, Clinical Presentation, CSF Analysis and Diagnostic Imaging

  • Chapter
Leptomeningeal Metastases

Part of the book series: Cancer Treatment and Research ((CTAR,volume 125))

Abstract

The incidence of leptomeningeal metastasis over the past several decades has increased among solid tumor patients and decerased in patients with hematologic malignancies. Improvements in systemic therapies are likely responsible for both changes; solid tumor patients are living longer and, threfore, are at higher risk to develop leptomeningeal tumors while patients with hematologic malignancy have benefitted from more aggressive central nervous system prophylaxis. Regardless, both types of patients present with symptoms referrable to multiple levels of the central nervous system and a careful dignostic approach incorporating cerebrospinal fluid studies and appropriate neuroimaging is critical.

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References

  1. Posner, J. B. and Chernik, N. L. Intracranial metastases from systemic cancer. Schoenberg, B. S. 579–592. 1978. New York, Raven Press. Advances in Neurology.

    Google Scholar 

  2. Olson ME, Chernik NL, Posner JB. Infiltration of leptomeninges by systemic cancer clinical and pathologic study. Arch Neurol 1974; 30:122–37.

    PubMed  CAS  Google Scholar 

  3. Wasserstrom WR, Glass JP, Posner JB. Diagnosis and Treatment of leptomeningeal metastases from solid tumors-experience with 90 patients. Cancer 1982; 49:759–72.

    PubMed  CAS  Google Scholar 

  4. Haaxma-Reiche, H. Neurological complications of leukemia. Vecht, C. J. (25(69)), 233–260. 1997. Elsevier Science B.V. Handbook of Clinical Neurology: Neuro-Oncology, Part III.

    Google Scholar 

  5. Singh SK, Agris JM, Leeds NE, Ginsberg LE. Intracranial leptomeningeal metastases: Comparison of depiction at FLAIR and contrast-enhanced MR imaging. Radiology 2000; 217:50–3.

    PubMed  CAS  Google Scholar 

  6. Singh SK, Leeds NE, Ginsberg LE. MR imaging of leptomeningeal metastases: Comparison of three sequences. Am J Neuroradiol 2002; 23:817–21.

    PubMed  Google Scholar 

  7. Bigner SH, Johnston WW. The diagnostic challenge of tumors manifested initially by the shedding of cells into cerebrospinal fluid. Acta Cytologica 1984; 28:29–36.

    PubMed  CAS  Google Scholar 

  8. Glass JP, Melamed M, Chernik NL, Posner JB. Malignant-Cells in cerebrospinal Fluid (CSF)-Meaning of a positive CSF cytology. Neurology 1979; 29:1369–75.

    PubMed  CAS  Google Scholar 

  9. Glantz MJ, Cole BF, Glantz LK, Cobb J, Mills P, Lekos A et al. Cerebrospinal fluid cytology in patients with cancer-Minimizing false-negative results. Cancer 1998; 82:733–9.

    Article  PubMed  CAS  Google Scholar 

  10. Chamberlain MC. Cytologically negative carcinomatous meningitis: Usefulness of CSF biochemical markers. Neurology 1998; 50:1173–5.

    PubMed  CAS  Google Scholar 

  11. van Oostenbrugge RJ, Twijnstra A. Presenting features and value of diagnostic procedures in leptomeningeal metastases. Neurology 1999; 53:382–5.

    PubMed  Google Scholar 

  12. Nakagawa H, Murasawa A, Kubo S, Nakajima S, Nakajima Y, Izumoto S et al. Diagnosis and treatment of patients with meningeal carcinomatosis. J Neuro-Oncol 1992; 13:81–9.

    Article  CAS  Google Scholar 

  13. Twijnstra A, Devisser BWO, Vanzanten AP. Diagnosis of leptomeningeal metastasis. Clin Neurol Neurosurg 1987; 89:79–85.

    Article  PubMed  CAS  Google Scholar 

  14. Rosen ST, Aisner J, Makuch RW, Matthews MJ, Ihde DC, Whitacre M et al. Carcinomatous leptomeningitis in small cell lung cancer-A clinicopathologic review of the National Cancer Institute Experience. Medicine 1982; 61:45–53.

    PubMed  CAS  Google Scholar 

  15. Theodore WH, Gendelman S. Meningeal carcinomatosis. Arch Neurol 1981; 38:696–9.

    PubMed  CAS  Google Scholar 

  16. Recht L, Straus DJ, Cirrincione C, Thaler HT, Posner JB. Central nervous system metastases from non-Hodgkins lymphoma-treatment and prophylaxis. Am J Med 1988; 84:425–35.

    Article  PubMed  CAS  Google Scholar 

  17. Surapaneni UR, Cortes JE, Thomas D, O'Brien S, Giles FJ, Koller C et al. Central nervous system relapse in adults with acute lymphoblastic leukemia. Cancer 2002; 94:773–9.

    Article  PubMed  Google Scholar 

  18. van Besien K, Ha CS, Murphy S, McLaughlin P, Rodriguez A, Amin K et al. Risk factors, treatment, and outcome of central nervous system recurrence in adults with intermediate-grade and immunoblastic lymphoma. Blood 1998; 91:1178–84.

    PubMed  Google Scholar 

  19. Yap HY, Yap BS, Tashima CK, Distefano A, Blumenschein GR. Meningeal carcinomatosis in breast cancer. Cancer 1978; 42:283–6.

    PubMed  CAS  Google Scholar 

  20. Boogerd W, Hart AAM, Vandersande JJ, Engelsman E. Meningeal Carcinomatosis in breast cancer-prognostic factors and influence of treatment. Cancer 1991; 67:1685–95.

    PubMed  CAS  Google Scholar 

  21. Chamberlain MC, Kormanik P. Carcinoma meningitis secondary to non-small cell lung cancer-combined modality therapy. Arch Neurol 1998; 55:506–12.

    Article  PubMed  CAS  Google Scholar 

  22. Burger B, Zimmermann M, Mann G, Kuhl J, Loning L, Reihm H et al. Diagnostic cerebrospinal fluid examination in children with acute lymphoblastic leukemia: Significance of low leukocyte counts with blasts or traumatic lumbar puncture. J Clin Oncol 2003; 21:184–8.

    Article  PubMed  Google Scholar 

  23. Mastrangelo R, Poplack D, Bleyer A, Riccardi R, Sather H, Dangio G. Report and recommendations of the Rome Workshop concerning poor prognosis acute lymphoblastic-leukemia in children-Biologic bases for staging, stratification, and treatment. Med Ped Oncol 1986; 14:191–4.

    CAS  Google Scholar 

  24. Abbott BL, Rubnitz JE, Tong X, Srivastava DK, Pui CH, Ribeiro RC et al. Clinical significance of central nervous system involvement at diagnosis of pediatric acute myeloid leukemia: a single institution's experience. Leukemia 2003; 17:2090–6.

    Article  PubMed  CAS  Google Scholar 

  25. Sariban E, Edwards B, Janus C, Magrath I. Central nervous system involvement in American Burkitts lymphoma. J Clin Oncol 1983; 1:677–81.

    PubMed  CAS  Google Scholar 

  26. Gururangan S, Sposto R, Cairo MS, Meadows AT, Finlay JL. Outcome of CNS disease at diagnosis in disseminated small noncleaved-cell lymphoma and B-cell leukemia: A Children's Cancer Group study. J Clin Oncol 2000; 18:2017–25.

    PubMed  CAS  Google Scholar 

  27. Haddy TB, Adde MA, Magrath IT. CNS involvement in small non-cleaved cell lymphoma-Is CNS disease per se a poor prognostic sign. J Clin Oncol 1991; 9:1973–82.

    PubMed  CAS  Google Scholar 

  28. Sandlund JT, Murphy SB, Santana VM, Behm F, Jones D, Berard CW et al. CNS involvement in children with newly diagnosed non-Hodgkin's lymphoma. J Clin Oncol 2000; 18:3018–24.

    PubMed  CAS  Google Scholar 

  29. Abrey LE, Rosenblum MK, DeAngelis LM. Sarcoidosis of the cauda equina mimicking leptomeningeal malignancy. J Neuro-Oncol 1998; 39:261–5.

    Article  CAS  Google Scholar 

  30. Sze G. Leptomeningeal tumor: the “Plain vanilla” approach remains the best. Am J Neuroradiol 2002; 23:745–6.

    PubMed  Google Scholar 

  31. Tsukada Y, Fouad A, Pickren JW, Lane WW. Central nervous system metastasis from breast carcinoma-autopsy study. Cancer 1983; 52:2349–54.

    PubMed  CAS  Google Scholar 

  32. Amer MH, Alsarraf M, Baker LH, Vaitkevicius VK. Malignant melanoma and central nervous system metastases-incidence, diagnosis, treatment and survival. Cancer 1978; 42:660–8.

    PubMed  CAS  Google Scholar 

  33. Jayson GC, Howell A, Harris M, Morgenstern G, Chang J, Ryder WD. Carcinomatous meningitis in patients with breast cancer-an aggressive disease variant. Cancer 1994; 74:3135–41.

    PubMed  CAS  Google Scholar 

  34. Lee JL, Rang YK, Kim TW, Chang HM, Lee GW, Ryu MH et al. Leptomeningeal carcinomatosis in gastric cancer. J Neuro-Oncol 2004; 66:167–74.

    Article  Google Scholar 

  35. Smith DB, Howell A, Harris M, Bramwell VHC, Sellwood RA. Carcinomatous meningitis associated with infiltrating lobular carcinoma of the breast. Eur J Surg Oncol 1985; 11:33–6.

    PubMed  CAS  Google Scholar 

  36. Kantarjian HM, O'Brien S, Smith TL, Cortes J, Giles FJ, Beran M et al. Results of treatment with Hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol 2000; 18:547–61.

    PubMed  CAS  Google Scholar 

  37. Pui CH, Dahl GV, Kalwinsky DK, Look AT, Mirro J, Dodge RK et al. Central nervous system leukemia in children with acute non-lymphoblastic leukemia. Blood 1985; 66:1062–7.

    PubMed  CAS  Google Scholar 

  38. Dusenbery KE, Howells WB, Arthur DC, Alonzo T, Lee JW, Kobrinsky N et al. Extramedullary leukemia in children with newly diagnosed acute myeloid leukemia-A report from the children's cancer group. J Ped Hematol Oncol 2003; 25:760–8.

    Article  Google Scholar 

  39. Peterson BA, Brunning RD, Bloomfield CD, Hurd DD, Gau JA, Peng GT et al. Central nervous system involvement in acute non-lymphocytic leukemia-A prospective study of adults in remission. Am J Med 1987; 83:464–70.

    Article  PubMed  CAS  Google Scholar 

  40. Colovic N, Bogdanovic A, Miljic P, Jankovic G, Colovic M. Central nervous system relapse in acute promyelocytic leukemia. Am J Hematol 2002; 71:60–l.

    Article  PubMed  CAS  Google Scholar 

  41. Breccia M, Carmosino I, Diverio D, De Santis S, De Propris MS, Romano A et al. Early detection of meningeal localization in acute promyelocytic leukaemia patients with high presenting leucocyte count. Br J Haematol 2003; 120:266–70.

    Article  PubMed  Google Scholar 

  42. Cramer SC, Glaspy JA, Efird JT, Louis DN. Chronic lymphocytic leukemia and the central nervous system: A clinical and pathological study. Neurology 1996; 46:19–25.

    PubMed  CAS  Google Scholar 

  43. Akintola-Ogunremi O, Whitney C, Mathur SC, Finch CN. Chronic lymphocytic leukemia presenting with symptomatic central nervous system involvement. Ann Hematol 2002; 81:402–4.

    Article  PubMed  CAS  Google Scholar 

  44. Cavanna L, Invernizzi R, Berte R, Vallisa D, Buscarini L. Meningeal involvement in multiple myeloma-Report of a case with cytologic and immunocytochemical diagnosis. Acta Cytologica 1996; 40:571–5.

    PubMed  CAS  Google Scholar 

  45. Evans LS, Hancock BW. Non-Hodgkin lymphoma. Lancer 2003; 362:139–46.

    Article  CAS  Google Scholar 

  46. van den Bent, M. J. Neurological complications of systemic lymphoma. Vecht, C. J. 261–287. 1997. Elsevier Science B.V. Handbook of Clinical Neurology; Neuro-Oncology, Part III.

    Google Scholar 

  47. Buckstein R, Lim W, Franssen E, Imrie KL. CNS prophylaxis and treatment in non-Hodgkin's lymphoma: Variation in practice and lessons from the literature. Leukemia Lymphoma 2003; 44:955–62.

    Article  PubMed  CAS  Google Scholar 

  48. Hoelzer, D. and Gokbuget, N. Treatment of lymphoblastic lymphoma in adults. Best Prac Res Clin Haematol 2003; 15:713–728.

    Article  CAS  Google Scholar 

  49. Ersboll J, Schultz HB, Thomsen BLR, Keiding N, Nissen NI. Meningeal involvement in non-Hodgkin's lymphoma: Symptoms, incidence, risk factors and treatment. Scand J Haematol 1985; 35:478–96.

    Google Scholar 

  50. Haioun C, Besson C, Lepage E, Simon D, Rose C, Tilly H et al. Incidence and rise factors of central nervous system (CNS) relapse in histologically aggressive non-Hodgkin's lymphoma (NHL) uniformly treated and receiving prophylaxis for CNS a GELA study on 974 patients. Blood 1999; 94:522A.

    Google Scholar 

  51. Zucca E, Conconi A, Mughal TI, Sarris AH, Seymour JF, Vitolo U et al. Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the International Extranodal Lymphoma Study Group. J Clin Oncol 2003; 21:20–7.

    Article  PubMed  CAS  Google Scholar 

  52. Kaufman DK, Habermann TM, Kurtin PJ, Oneill BP. Neurological complications of peripheral and cutaneous T-cell lymphomas. Annals of Neurology 1994; 36:625–9.

    Article  PubMed  CAS  Google Scholar 

  53. Teshima T, Akashi K, Shibuya T, Taniguchi S, Okamura T, Harada M et al. Central nervous system involvement in adult T-cell leukemia lymphoma. Cancer 1990; 65:327–32.

    PubMed  CAS  Google Scholar 

  54. Balmaceda C, Gaynor JJ, Sun M, Gluck JT, DeAngelis LM. Leptomeningeal tumor in primary central nervous system lymphoma-recognition, significance, and implications. Ann Neurol 1995; 38:202–9.

    Article  PubMed  CAS  Google Scholar 

  55. Robertson PL, Zeltzer PM, Boyett JM, Rorke LB, Allen JC, Geyer JR et al. Survival and prognostic factors following radiation therapy and chemotherapy for ependymomas in children: a report of the Children's Cancer Group. J Neurosurg 1998; 88:695–703.

    Article  PubMed  CAS  Google Scholar 

  56. Saito R, Kumabe T, Jokura H, Shirane R, Yoshimoto T. Symptomatic spinal dissemination of malignant astrocytoma. J Neuro-Oncol 2003; 61:227–35.

    Article  Google Scholar 

  57. Zeltzer PM, Boyett JM, Finlay JL, Albright AL, Rorke LB, Milstein JM et al. Metastasis stage, adjuvant treatment, and residual tumor are prognostic factors for medulloblastoma in children: Conclusions from the Children's Cancer Group 921 randomized phase III study. J Clin Oncol 1999; 17:832–45.

    PubMed  CAS  Google Scholar 

  58. Kortmann RD, Kuhl J, Timmermann B, Mittler U, Urban C, Budach V et al. Postoperative neoadjuvant chemotherapy before radiotherapy as compared to immediate radiotherapy followed by maintenance chemotherapy in the treatment of medulloblastoma in childhood: Results of the German prospective randomized trial HIT '91. Int J Radiat Oncol Biol Phys 2000; 46:269–79.

    Article  PubMed  CAS  Google Scholar 

  59. Fouladi M, Gajjar A, Boyett JM, Walter AW, Thompson SJ, Merchant TE et al. Comparison of CSF cytology and spinal magnetic resonance imaging in the detection of leptomeningeal disease in pediatric medulloblastoma or primitive neuroectodermal tumor. J Clin Oncol 1999; 17:3234–7.

    PubMed  CAS  Google Scholar 

  60. DeAngelis LM. Current diagnosis and treatment of leptomeningeal metastasis. J Neuro-Oncol 1998; 38:245–52.

    Article  CAS  Google Scholar 

  61. Posner, J. B. Leptomeningeal metastases in Neurologic Complications of Cancer. 1st, 143–171. 1995. Philadelphia, F.A. Davis Company. Contemporary Neurology Series vol 45.

    Google Scholar 

  62. Grossman SA, Krabak MJ. Leptomeningeal carcinomatosis. Cancer Treat Rev 1999; 25:103–19.

    Article  PubMed  CAS  Google Scholar 

  63. Chamberlain MC. Leptomeningeal metastases: A review of evaluation and treatment. J Neuro-Oncol 1998; 37:271–84.

    Article  CAS  Google Scholar 

  64. Mackintosh FR, Colby TV, Podolsky WJ, Burke JS, Hoppe RT, Rosenfelt FP et al. Central nervous system involvement in non-Hodgkins lymphoma-An analysis of 105 cases. Cancer 1982; 49:586–95.

    PubMed  CAS  Google Scholar 

  65. Hitchins RN, Bell DR, Woods RL, Levi JA. A prospective randomized trial of single-agent versus combination chemotherapy in meningeal carcinomatosis. J Clin Oncol 1987; 5:1655–62.

    PubMed  CAS  Google Scholar 

  66. Kaplan JG, Desouza TG, Farkash A, Shafran B, Pack D, Rehman F et al. Leptomeningeal metastases-comparison of clinical features and laboratory data of solid tumors, lymphomas and leukemias. J Neuro-Oncol 1990; 9:225–9.

    Article  CAS  Google Scholar 

  67. Balm M, Hammack J. Leptomeningeal carcinomatosis-Presenting features and prognostic factors. Arch Neurol 1996; 53:626–32.

    PubMed  CAS  Google Scholar 

  68. Pedersen AG, Olsen J, Nasiell M. Cerebrospinal fluid cytology diagnosis of meningeal carcinomatosis in patients with small cell carcinoma of the lung-A study of interobserver and intraobserver variability. Acta Cytologica 1986; 30:648–52.

    PubMed  CAS  Google Scholar 

  69. Little JR, Dale AJD, Okazaki H. meningeal carcinomatosis-clinical manifestations. Arch Neurol 1974; 30:138–43.

    PubMed  CAS  Google Scholar 

  70. Fizazi K, Asselain B, VincentSalomon A, Jouve M, Dieras V, Palangie T et al. Meningeal carcinomatosis in patients with breast carcinoma-Clinical features, prognostic factors, and results of a high-dose intrathecal methotrexate regimen. Cancer 1996; 77:1315–23.

    Article  PubMed  CAS  Google Scholar 

  71. Straathof CSM, de Bruin HG, Dippel DWJ, Vecht CJ. The diagnostic accuracy of magnetic resonance imaging and cerebrospinal fluid cytology in leptomeningeal metastasis. J Neurol 1999; 246:810–4.

    Article  PubMed  CAS  Google Scholar 

  72. Dux R, Kindlerrohrborn A, Annas M, Faustmann P, Lennartz K, Zimmermann CW. A standardized protocol for flow cytometric analysis of cells isolated from cerebrospinal fluid. J Neurol Sci 1994; 121:74–8.

    Article  PubMed  CAS  Google Scholar 

  73. van Oostenbrugge RJ, Hopman AHN, Lenders MH, van Heerde P, Arends JW, Ramaekers FCS et al. Detection of malignant cells in cerebrospinal fluid using fluorescence in situ hybridization. J Neuropathol Exp Neurol 1997; 56:743–8.

    Article  PubMed  Google Scholar 

  74. Roma AA, Garcia A, Avagnina A, Rescia C, Eisner B. Lymphoid and myeloid neoplasms involving cerebrospinal fluid: Comparison of morphologic examination and immunophenotyping by flow cytometry. Diag Cytopathol 2002; 27:271–5.

    Article  Google Scholar 

  75. Hovestadt A, Henzenlogmans SC, Vecht CJ. Immunohistochemical analysis of the cerebrospinal fluid for carcinomatous and lymphomatous leptomeningitis. Br J Cancer 1990; 62:653–4.

    PubMed  CAS  Google Scholar 

  76. Boogerd W, Vroom TM, Vanheerde P, Delariviere GB, Peterse JL, Vandersande JJ. CSF cytology versus immunocytochemistry in meningeal carcinomatosis. J Neurol Neurosurg Psychiatry 1988; 51:142–5.

    Article  PubMed  CAS  Google Scholar 

  77. Jorda M, Ganjei-Azar P, Nadji M. Cytologic characteristics of meningeal carcinomatosis-Increased diagnostic accuracy using carcinoembryonic antigen and epithelial membrane antigen immunocytochemistry. Arch Neurol 1998; 55:181–4.

    Article  PubMed  CAS  Google Scholar 

  78. Kranz BR. Detection of rare malignant cells and their apoptotic fragments in cerebrospinal fluid. Lancet 2000; 356:1242–4.

    Article  PubMed  CAS  Google Scholar 

  79. de Haas V, Vet RJWM, Verhagen OJHM, Kroes W, van den Berg H, van der Schoot CE. Early detection of central nervous system relapse by polymerase chain reaction in children with B-precursor acute lymphoblastic leukemia. Ann Hematol 2002; 81:59–61.

    Article  PubMed  CAS  Google Scholar 

  80. Galoin S, Daste G, Apoil PA, Chollet F, Roda D, Blancher A et al. Polymerase chain reaction on cerebrospinal fluid cells in the detection of leptomeningeal involvement by B-cell lymphoma and leukaemia: a novel strategy and its implications. Br J Haematol 1997; 99:122–30.

    Article  PubMed  CAS  Google Scholar 

  81. Rhodes CH, Glantz MJ, Glantz L, Lekos A, Sorenson GD, Honsinger C et al. A comparison of polymerase chain reaction examination of cerebrospinal fluid and conventional cytology in the diagnosis of lymphomatous meningitis. Cancer 1996; 77:543–8.

    Article  PubMed  CAS  Google Scholar 

  82. Twijnstra A, Vanzanten AP, Nooyen WJ, Devisser BWO. Sensitivity and specificity of single and combined tumor markers in the diagnosis of leptomeningeal metastasis from breast cancer. J Neurol Neurosurg Psychiatry 1986; 49:1246–50.

    PubMed  CAS  Google Scholar 

  83. Fleisher M, Wasserstrom WR, Schold SC, Schwartz MK, Posner JB. Lactic dehydrogenase isoenzymes in the cerebrospinal fluid of patients with systemic cancer. Cancer 1981; 47:2654–9.

    PubMed  CAS  Google Scholar 

  84. van den Bent MJ, Lamers CHJ, 't Veer MB, Smitt PAES, Bolhuis RLH, Gratama JW. Increased levels of soluble CD27 in the cerebrospinal fluid are not diagnostic for leptomeningeal involvement by lymphoid malignancies. Ann Hematol 2002; 81:187–91.

    Article  PubMed  CAS  Google Scholar 

  85. Rogers LR, Duchesneau PM, Nunez C, Fishleder AJ, Weick JK, Bauer LJ et al. Comparison of cisternal and lumbar CSF examination in leptomeningeal metastasis. Neurology 1992; 42:1239–41.

    PubMed  CAS  Google Scholar 

  86. Chamberlain MC, Kormanik PA, Glantz MJ. A comparison between ventricular and lumbar cerebrospinal fluid cytology in adult patients with leptomeningeal metastases. Neuro-Oncol 2001; 3:42–5.

    PubMed  CAS  Google Scholar 

  87. Gajjar A, Fouladi M, Walter AW, Thompson SJ, Reardon DA, Merchant TE et al. Comparison of lumbar and shunt cerebrospinal fluid specimens for cytologic detection of leptomeningeal disease in pediatric patients with brain tumors. J Clin Oncol 1999; 17:1825–8.

    PubMed  CAS  Google Scholar 

  88. Freilich RJ, Krol G, DeAngelis LM. Neuroimaging and cerebrospinal fluid cytology in the diagnosis of leptomeningeal metastasis. Ann Neurol 1995; 38:51–7.

    Article  PubMed  CAS  Google Scholar 

  89. Zeiser R, Burger JA, Bley TA, Windfuhr-Blum M, Schulte-Monting J, Behringer DM. Clinical follow-up indicates differential accuracy of magnetic resonance imaging and immunocytology of the cerebral spinal fluid for the diagnosis of neoplastic meningitis-a single centre experience. Br J Haematol 2004; 124:762–8.

    Article  PubMed  Google Scholar 

  90. Chamberlain MC. Comparative spine imaging in leptomeningeal metastases. J Neuro-Oncol 1995; 23:233–8.

    Article  CAS  Google Scholar 

  91. Yousem DM, Patrone PM, Grossman RI. Leptomeningeal metastases-MR evaluation. J Comp Assis Tomogr 1990; 14:255–61.

    Article  CAS  Google Scholar 

  92. Gomori JM, Heching N, Siegal T. Leptomeningeal metastases: Evaluation by gadolinium enhanced spinal magnetic resonance imaging. J Neuro-Oncol 1998; 36:55–60.

    Article  CAS  Google Scholar 

  93. Hsia AW, Katz JS, Hancock SL, Peterson K. Post-irradiation polyradiculopathy mimics leptomeningeal tumor on MRI. Neurology 2003; 60:1694–6.

    PubMed  Google Scholar 

  94. Jeha LE, Sila CA, Lederman RJ, Prayson RA, Isada CM, Gordon SM. West Nile virus infection-A new acute paralytic illness. Neurology 2003; 61:55–9.

    PubMed  CAS  Google Scholar 

  95. Schumacher M, Orszagh M. Imaging techniques in neoplastic meningiosis. J Neuro-Oncol 1998; 38:111–20.

    Article  CAS  Google Scholar 

  96. Pannullo SC, Reich JB, Krol G, Deck MDF, Posner JB. MRI changes in intracranial hypotension. Neurology 1993; 43:919–26.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. University Hospital Groningen, The Netherlands

    Roelien H. Enting M.D.

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  1. Roelien H. Enting M.D.
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Editors and Affiliations

  1. Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10021

    Lauren E. Abrey M.D.

  2. Department of Neurology, University of Southern California, Norris Comprehensive Cancer Center and Hospital, Los Angeles, CA, 90033

    Marc C. Chamberlain M.D.

  3. Departments of Neurosurgery, Bioengineering & Molecular Genetics, University of Illinois at Chicago, Chicago, IL, 60612

    Herbert H. Engelhard M.D., PhD.

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Enting, R.H. (2005). Leptomeningeal Neoplasia: Epidemiology, Clinical Presentation, CSF Analysis and Diagnostic Imaging. In: Abrey, L.E., Chamberlain, M.C., Engelhard, H.H. (eds) Leptomeningeal Metastases. Cancer Treatment and Research, vol 125. Springer, Boston, MA. https://doi.org/10.1007/0-387-24199-X_2

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