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Washington University Experience | NEOPLASMS (METASTASES) | Meningeal | 12A2 Metastasis, lepto, vulva (Case 12) _8
The transverse sections of the brainstem show multiple hemorrhagic lesions involving the midbrain and pons. There is normal pigmentation of substantia nigra and locus cerulei. The ventricular system has a normal configuration and is lined by smooth, glistening ependyma. The aqueduct and fourth ventricle have a normal configuration and are lined by a smooth, glistening ependyma. The midbrain, pons, and medulla shows widespread, regionally continuous involvement of the leptomeninges by the carcinoma in a pattern consistent with leptomeningeal carcinomatosis. There is multifocal extension of the neoplasm into the brain parenchyma along Virchow-Robin spaces as well as invasion of cranial nerve roots. Immunostains were performed to further characterize the neoplasm. The tumor cells show strong nuclear expression of P63 and strong cytoplasmic expression of CK5/6.
