title: Diagnosing lymphoproliferative disorders involving the cerebrospinal fluid: increased sensitivity using flow cytometric analysis.
abstract: Flow cytometric immunophenotypic analysis (FCA) can be performed to evaluate lymphoid cells in cerebrospinal fluid (CSF). We compared this method with conventional cytologic diagnosis to determine its utility. A retrospective comparison of 35 consecutive CSF flow cytometry results with the corresponding cytologic diagnoses was undertaken. Twenty-five of 35 CSFs (71%) were successfully analyzed by flow cytometry. The 10 samples which could not be analyzed were either too old (greater than 3 days) or had an insufficient number of cells. A total of 9 lymphomas was detected: 4 by both flow cytometry and cytology; 2 by cytology alone; and 3 by flow cytometry alone. This represents a 50% increase in the detection of lymphoproliferative disorders in CSF by a combination of flow cytometry and cytology vs. cytology alone. Furthermore, in 3 cases with follow-up where the cytologic diagnosis was "atypical cells of undetermined significance" and the flow cytometric findings were negative for malignancy, the clinical course confirmed a benign pleocytosis in all three. We conclude that flow cytometric analysis markedly improves sensitivity when used in combination with cytology in the evaluation of lymphoid cells in CSF.
authors.affiliation: Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: French
authors.forename: D M
authors.initials: DM
authors.lastname: Dorfman
authors.forename: G
authors.initials: G
authors.lastname: Shaheen
authors.forename: E S
authors.initials: ES
authors.lastname: Cibas
mesh_terms: D014408:Biomarkers, Tumor / Q000138:chemical synthesis; D002555:Cerebrospinal Fluid / Q000166:cytology; D003581:Cytodiagnosis / Q000379:methods; D005434:Flow Cytometry / Q000379:methods*; D006801:Humans; D016130:Immunophenotyping; D008232:Lymphoproliferative Disorders / Q000134:cerebrospinal fluid* / Q000473:pathology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor