Cerebrospinal fluid (CSF) examination for malignant cells is a time-honored procedure, used in the diagnosis of primary and metastatic central nervous system (CNS) tumors including hematolymphoid neoplasms. Its utility in assessing the results of therapy has also been stressed.1'1 An early diagnosis of neoplastic meningitis may assist in palliation and stabilization of the patient, preventing further deterioration.'21 Major studies have shown 20-40% of patients harboring malignant CNS tumors to manifest with a positive CSF cytology.1'1 Neoplastic meningitis is seen in 5-10% of patients with solid tumors such as carcinoma of the breast/lung, malignant melanoma and rarely gastric carcinoma.'21 Clinically121 and even by radiological means such as computed tomography or magnetic resonance imaging (MRI), tuberculoma/tuberculous meningitis may mimic a brain tumoreoplastic meningitis.13"51 Prognosis of patients with CNS metastasis is poor'21 while, the patients with tuberculoma respond well to antituberculous therapy (ATT).|3i4i Hence, a distinction between the two conditions is critical. Although, a brain biopsy is useful, it is not always a feasible option.'41 In a situation like this, a simple CSF cytology proves more useful.We report a case to exemplify this fact.
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