title: Automated cerebrospinal fluid cytology: limitations and reasonable applications.
abstract: OBJECTIVE
  To evaluate the precision and clinical applicability of the Bayer ADVIA 120 cytometer (Bayer Healthcare, Fernwald, Germany) for cerebrospinal fluid (CSF) cell count and differentiation.
  
  
  METHODS
  One hundred six analyses of CSF from 98 patients by the ADVIA 120 were compared with routine cell count and microscopic differentiation. Correlation coefficients were calculated.
  
  
  RESULTS
  In general, the total cell counts of both methods correlated well. The best correlations were seen at higher cell counts, > or = 100 cells per microliter with < 100 erythrocytes per microliter. The best correlations of cell differentiation were seen for lymphocytes and neutrophils, while the results for monocytes and eosinophils were less precise. In some cases, considerable differences between automated and microscopic cell counts and differentiation were seen that were relevant to clinical decision making. The detection of pathologic cell types, such as hemosiderophages, mitoses and neoplastic cells, was not provided by automated cytometry.
  
  
  CONCLUSIONS
  When experienced personnel are not available, a preliminary cell count and differentiation between neutrophilic and lymphocytic reactions by automated cytometry may be valuable in allowing initial therapeutic decision making. Since the detection of pathologic cell types is not provided and the precision at low cell counts is only moderate, a personal microscopic evaluation of each sample is still indispensable to avoid misdiagnoses.
authors.affiliation: Department of Neurology, University of Göttingen, Göttingen, Germany. herwig.strik@med.uni-goettingen.de
authors.forename: Herwig
authors.initials: H
authors.lastname: Strik
authors.forename: Hilmar
authors.initials: H
authors.lastname: Luthe
authors.forename: Ingelore
authors.initials: I
authors.lastname: Nagel
authors.forename: Bettina
authors.initials: B
authors.lastname: Ehrlich
authors.forename: Mathias
authors.initials: M
authors.lastname: Bahr
mesh_terms: D002452:Cell Count / Q000295:instrumentation / Q000379:methods; D002490:Central Nervous System / Q000473:pathology; D002555:Cerebrospinal Fluid / Q000166:cytology*; D004912:Erythrocytes / Q000166:cytology; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005434:Flow Cytometry / Q000295:instrumentation* / Q000379:methods; D006098:Granulocytes / Q000166:cytology; D006801:Humans; D007958:Leukocyte Count; D016014:Linear Models; D008214:Lymphocytes / Q000166:cytology; D008223:Lymphoma / Q000134:cerebrospinal fluid / Q000473:pathology; D009000:Monocytes / Q000166:cytology; D010954:Plasmacytoma / Q000134:cerebrospinal fluid / Q000473:pathology; D011008:Pneumococcal Infections / Q000134:cerebrospinal fluid / Q000473:pathology; D012680:Sensitivity and Specificity; D012984:Software