Ra. Prayson et Df. Fischler, CEREBROSPINAL-FLUID CYTOLOGY - AN 11-YEAR EXPERIENCE WITH 5951 SPECIMENS, Archives of pathology and laboratory medicine, 122(1), 1998, pp. 47-51
Objective. - Cerebrospinal fluid (CSF) diagnoses encompass a wide spec
trum of conditions. The authors review one institution's CSF cytology
results over an Ii-year period. Design and Setting. - A retrospective
study of 5951 CSF specimens generated between 1985 and 1995. Specimens
from pediatric patients (< 19 years of age) from the same time period
were separately identified. Results. - A total of 5561 adult and 390
pediatric CSF specimens were interpreted. A diagnosis of ''negative fo
r malignant cells'' was assigned in 5171 (93%) of the adult cases and
in 351 (90%) of the pediatric cases. Specific infectious organisms wer
e identified in 26 adult specimens and one pediatric specimen. Cryptoc
occus was the most common infectious agent observed (n = 23 adults), a
nd Toxoplasma was the sole pediatric infectious agent. Two hundred sev
enty-six (5%) adult cases and 31 (8%) pediatric cases were positive fo
r malignant cells. Diagnoses ineluded metastatic tumors (adult, 140 [5
1%]; pediatric, 0); lymphoma/leukemia (adult, 112 [41%]; pediatric, 4
[13%]); malignant unclassified neoplasms (adult, 9 [3%]; pediatric, 0)
; and primary central nervous system neoplasms (adult, 12 [4%]; pediat
ric, 27 [87%]). Medulloblastoma was the most common pediatric neoplasm
(n = 21). There were 105 (2%) adult cases and 8 (2%) pediatric cases
with atypical cells present. Atypical lymphoid cells were the most com
mon type in adult cases (53%). Conclusions. - ln our experience, infec
tious agents were rarely identified in pediatric CSF specimens. In adu
lt specimens, the most commonly identified organisms was Cryptococcus.
Primary central nervous system neoplasms accounted for a higher perce
ntage of CSF specimens in the pediatric population than in the adult p
opulation. The most commonly identified malignancy in adults was metas
tatic neoplasms, and in children, medulloblastoma.