Assessment of the Utility of Cytology and Flow Cytometry of Cerebrospinal Fluid Samples in Clinical Practice

Acta Cytol. 2018;62(2):130-136. doi: 10.1159/000487070. Epub 2018 Mar 6.

Abstract

Objectives: We sought to assess the utility and limitations of both flow cytometry (FC) and cytology for the analysis of cerebrospinal fluid (CSF) in a practical clinical setting.

Methods: A total of 393 consecutive CSF samples from 171 patients submitted for both cytomorphologic and FC assessments were analyzed.

Results: Both FC and cytology findings were negative for malignancy in 315/393 samples (80%), and either positive (POS) or suspicious/atypical (SUSP/AT) in 7% of samples. This resulted in high agreement between FC and cytology (87%). Minor discrepancies were present in 4% of the cases. In 28 samples, an abnormal population was detected by FC but not by cytology.

Conclusions: FC and cytology are important complementary methods for analyzing CSF samples. In cases where cytology is SUSP/AT and FC is inconclusive or negative, additional specimens should be submitted for immunostaining, cytogenetics, and/or molecular studies.

Keywords: Cerebrospinal fluid; Cytology; Flow cytometry; Leptomeningeal disease; Leukemia; Lymphoma.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cerebrospinal Fluid / cytology*
  • Child
  • Child, Preschool
  • Cytological Techniques*
  • Female
  • Flow Cytometry*
  • Hematologic Neoplasms / cerebrospinal fluid*
  • Hematologic Neoplasms / pathology*
  • Humans
  • Male
  • Meningeal Neoplasms / cerebrospinal fluid*
  • Meningeal Neoplasms / pathology*
  • Middle Aged
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • Young Adult