PMC9066584_01
Cytopathologic finding of cerebrospinal fluid revealing large malignant cells, some with a signet-ring appearance.
acc-09-01-6-g001.jpg
PMC9066584_01_acc-09-01-6-g001.jpg
f1
Subsequently, a lumbar puncture was performed and CSF analysis was compatible with LMC (Figure 1).
A, B, C: T1-weighted gadolinium-enhanced MRI scan showing brain meningeal enhancement with involvement of the subarachnoid space; D: T1-weighted gadolinium-enhanced MRI scan showing cerebellar and bulbar meningeal enhancement.
acc-09-01-6-g002.jpg
PMC9066584_01_acc-09-01-6-g002.jpg
f2
Brain magnetic resonance imaging (MRI) was performed, showing leptomeningeal enhancement as well as malignant infiltrates at the entire cerebrum (Figure 2).
PMC9066584_02
Brain MRI, axial FLAIR, revealing hypersignal and locoregional thickening of the superior frontal sulcus.
acc-09-01-6-g003.jpg
PMC9066584_02_acc-09-01-6-g003.jpg
f3
Head CT scan revealed a hyperintense right frontoparietal lesion with surrounding oedema, suggestive of malignancy on brain MRI (Figure 3).
Neoplastic cells in the CSF with pleomorphic nuclei and prominent nucleoli.
acc-09-01-6-g004.jpg
PMC9066584_02_acc-09-01-6-g004.jpg
f4
CSF analysis revealed atypical malignant signet-ring cells and gastric adenocarcinoma LMC was assumed (Figure 4).