title: Cytomorphologic and Flow Cytometric Analysis of Cerebrospinal Fluid with T-Cell Lymphoma Involvement: A Retrospective Study of Rare Cases.
abstract: OBJECTIVE
  To compare the efficacy of conventional cytomorphologic analysis and flow cytometry (FC) in the diagnosis of T-cell lymphoma in the cerebrospinal fluid (CSF).
  
  
  METHODS
  We performed a retrospective review of CSF samples from 2002 to 2012 that showed involvement of a T-cell lymphoma, either by cytomorphologic analysis and/or FC. Patients' demographics, clinical history and follow-up were assessed.
  
  
  RESULTS
  Thirty-nine CSF samples were identified from 9 patients. A definitive diagnosis of T-cell lymphoma involvement was made by cytomorphologic analysis and FC in 6 (15.4%) and 39 (100.0%) specimens, respectively. In specimens with definitive cytopathologic diagnoses, the cytomorphologic features included increased cellularity, a monotonous lymphoid population and large, atypical lymphoid cells. Considering cytomorphologic features only, 9 specimens demonstrated atypical lymphocytes not fulfilling the criteria for malignancy, and 24 specimens were negative for malignancy.
  
  
  CONCLUSIONS
  CSF with T-cell lymphoma involvement may yield paucicellular or acellular specimens depending on the volume of the CSF, the time interval between specimen collection and specimen processing and the application of preservative to CSF. The rate of detection of T-cell lymphoma in the CSF by FC is unequivocally higher than by cytomorphologic analysis. Careful attention to clinical history is crucial, as FC testing may be tailored to evaluate for T-cell lymphoproliferative disorders in limited samples.
authors: Divisions of Cytopathology and Hematopathology, Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Md., USA.
authors: Irem
authors: I
authors: Onur
authors: Genevieve M
authors: GM
authors: Crane
authors: Zahra
authors: Z
authors: Maleki
mesh_terms: D000328:Adult; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006801:Humans; D016399:Lymphoma, T-Cell / Q000134:cerebrospinal fluid* / Q000473:pathology*; D008232:Lymphoproliferative Disorders / Q000134:cerebrospinal fluid / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000473:pathology