Cerebrospinal fluid cytology examination

Last updated: Monday, 06, August, 2007

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Item Process
Specimen

CSF specimens are obtained at lumbar puncture. 

Alternative collection methods include cisternal puncture, shunt preparations or ventricular sampling (intraoperatively or transfontanelle). 

Rapid transfer of the specimen to the laboratory is essential for immediate preparation. 

Contact the laboratory if the specimen is taken out of hours.

Method

Preparations using cytocentrifugation and/or membrane filtration. 

Papanicolaou, Romanowsky or Wright's stain.

Immunohistochemical stains may be undertaken which would include assessment of surface markers for cases of lymphoma/leukaemia.

Application

Primarily used in monitoring neoplasia - leukaemia, lymphoma, CNS metastases and primary CNS tumours.

Interpretation

Accuracy of tumour diagnosis relates directly to the extent of involvement of leptomeninges by disease process. 

Diagnostic accuracy is enhanced if multiple examinations of CSF are made. 

Risk of false positive diagnoses for lymphomas and leukaemias which may be associated with bloodstained taps.

Reference

Timperley WR. In: Gray W and McKee GT eds. Diagnostic Cytopathology.  2nd ed. Churchill Livingstone 2003.