Cerebrospinal fluid cytologic findings in multiple sclerosis - A comparison between patient subgroups

OBJECTIVE: To compare cytologic findings in cerebrospinal fluid (CSF) in va rious subgroups of multiple sclerosis (MS) patients. STUDY DESIGN: CSF from 77 patients with clinically definitive or probable M S was examined by means of qualitative cytology. After the cell count was d etermined in a Fuchs-Rosenthal chamber, slides were prepared by the cytosed imentation method and stained with May-Grunwald-Giemsa stain and oil red O and, whenever possible, with Papanicolaou stain and toluidine blue. In addi tion to the differential cell count, the lymphocyte/monocyte ratio, percent age of activated forms in the lymphocytic and monocytic series, presence an d percentage gf lymphoplasmacytes and mature plasma cells, presence of lipo phages, lymphophages and presence of mitotic figures were evaluated. RESULTS: The following statistically significant differences were found bet ween the various MS subgroups: (1) higher prevalence of mitotic figures in the primary progressive MS subgroup; (2) higher prevalence of foam cells an d lymphophages and lower prevalence of CSF pleocytosis in more severely dis abled patients; (3) lower cell count, lower prevalence of CSF pleocytosis, lower lymphocyte/monocyte ratio and lower prevalence of lymphoplasmacytes i n treated patients; and (4) higher prevalence of mature plasma cells and li pophages in MS patients with disease of longer duration. CONCLUSION: The differences observed in the various MS subgroups may reflec t certain aspects of MS pathogenesis. Qualitative CSF cytology may therefor e be useful for both clinicians and neuroimmunologists. Qualitative cytolog y of CSF is an important diagnostic method that should never be omitted fro m an examination of CSF from patients with MS.