#00065589

Elderly female was diagnosed as triple negative invasive ductal carcinoma involving both breast and right axillary lymph node. Patient was staged as locally advanced triple negative breast carcinoma and started on treatment with chemotherapy.

After 6 months, this was followed by disease progression with evidence of leptomeningeal disease. Patient presented with complain of severe headache since few days and underwent an MRI (Magnetic Resonance Imaging) of brain and CSF (Cerebrospinal fluid) aspiration (by aspiration through Omaya reservoir). MRI showed white matter changes suggestive of leukoencephalopathy. 

Smear prepared from CSF shows significant number of cells with enlarged and moderately pleomorphic nuclei. Chromatin is coarsely granular with conspicuous nuclei. Cytoplasm is minimal to moderate amount with plenty of surface blebs. Immunochemistry performed on cytospin smear showed strong positive AE1/AE3 and negative CD45. This immunochemistry and morphological profile are consistent with metastatic carcinoma of mammary origin.