Cerebrospinal fluid cytology

A22. Adam, R, Taborsky, L., Rrucha, M., Sobek, O., et al, Cerebrospinal Fluid Cytology on CD-ROM. Medica News Rublishers, Prague, 2000. 

Filtering cells and cell fractions from fluid media. These particles, after concentration by filtration, may be examined through subsequent quantitative or qualitative analysis. The filtration techniques also have applications in fields related to immunology and implantation of tissues as well as in cytological evaluation of cerebrospinal, fluid. 

Because the risk of central nervous system (CNS) involvement is high, regardless of cerebrospinal fluid (CSF) cytology all patients with acute lymphocytic leukemia (ALL) receive intrathecal prophylaxis. 

Acute inflammatoiy demyelinating polyneuropathy is a common cause of reversible paralysis. Acute inflammatory demyelinating polyneuropathy (AIDP), the classic form of the Guillain-Barre syndrome, often begins a week or two after recovery from cytomegalovirus, Epstein-Barr virus or Mycoplasma infection. Patients present with rapidly advancing symmetrical weakness, loss of deep tendon reflexes, often with distal numbness, and limb or back pain. Cerebrospinal fluid (CSF) protein concentration is elevated, but in most cases there is little or no increase in number of inflammatory cells in the CSF. This albumino-cytologic dissociation contrasts with the elevation of both... 

Antithrombin HI (ATHI). There are only a few references concerning the evaluation of antithrombin III (AT III) in cerebrospinal fluid. Extension of evaluated groups of patients is not sufficient a comparison with other CSF protein fractions and with CSF cytological findings was not done. Some experimental works describe the vasorelaxant effect of AT III on brain arteries, and the inhibitory influence of AT III in subarachnoid hemorrhage on onset of vasospasms is expected (W2). AT III also plays a possible role in etiopathogenesis of ischemic stroke (A19, W2). 

Antithrombin HI in cerebrospinal fluid can be easily denoted as an inflammatory marker. Correlations with levels of immunoglobulins, their intrathecal oligo-clonal synthesis, complement components, and acute-phase reactants confirm such concepts. Correlations with apolipoproteins and with the presence of lipophagic macrophages in cytological preparations confirm the elevation of CSF AT III levels when a destructive lesion of the CNS is present. 

These apolipoproteins are present in normal cerebrospinal fluid, but only in low concentrations. In the presence of lipophagic elements in CSF cytology, the findings of the concentrations of apolipoproteins in cerebrospinal fluid were clearly improved. 

In patients with multiple sclerosis, a qualitative cytological examination should always be carried out. Besides the finding of plasmocytic forms, which are considered to be one of the proofs of intrathecal synthesis of immunoglobulins, this examination also provides invaluable information concerning the reaction of the monocyte-macrophage system in the CSF compartment. It should be noted on the scope of biochemical examinations of cerebrospinal fluid in multiple sclerosis that it is most important to return to the simple and inexpensive method. 

Other neurological diseases accompanied by the manifestation of monocytic oligocytosis this is the most complicated issue of cytological diagnostics in CSF. Borreliosis can be differentiated again by the presence of an antibody response in cerebrospinal fluid. 

A5. Adam, P., Cytological findings in cerebrospinal fluid in ischemic vascular lesions of central nervous system. In 15th International Congress of Slovak and Czech Neurologists, Bratislava, p. 10, 1994. 

A15. Adam, R, Nekola, R, Havrdova, E., et al., Monitoring of orosomucoid levels in cerebrospinal fluid in comparison with CSE cytological findings. Clin. Biochem. Metab. 5,47-50 (1997). 

An additional useful aspect for the clonality analysis is the screening of cerebrospinal fluid to exclude the central nervous system involvement in patients with acute lymphoblastic leukemia of both B- and T-cell lineage. This method is more accurate than conventional cytology. 

Leptomeningeal metastasis (EM) occurs in 5% of patients with breast cancer. This complication can lead to neurological deterioration without early diagnosis and treatment. This is complicated by the fact that 25% of cerebrospinal fluid (CSF) samples produce false-negative results when examined cytologically. Dekker et al. have developed an MS-based method to investigate protein expression... 

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