CYTOLOGY OF CSF

1. PRESENTATION ON “CYTOLOGY OF CSF” BY MAIMOON ZAFAR

2. WHAT IS CSF? The cerebrospinal Fluid [CSF] is clear colorless transparent The Tissue fluid present in the cerebral ventricles spinal canal

3. WHAT IS PRESENT IN OF CSF? Proteins Glucose Cholesterol Na+ Ca+ Urea Creatinine Lactic acid

4. SPECIMEN COLLECTION Lumbar puncture or spinal tap

5. PROCESSING OF CSF IN CYTOLOGY Check Physical Appearance (gross) Slide Making (cytocentrifuge technique) Staining of slides Microscopic evaluation of slides

6. PROCESSING OF CSF IN CYTOLOGY contd… PHYSICAL APPEREANCE Normal Crystal clear, colorless Abnormal hazy, cloudy, turbid, milky, bloody, Xanthrochromic Unclear specimens may contain increased lipids, proteins, cells or bacteria Clots indicate traumatic tap Milky – increased lipids Oily – contaminated with x-ray Xanthrochromic – Yellowing discoloration of supernatant (may be pinkish, or orange Brown or Dark CSF – methemoglobin from a hematoma. Green CSF --hyperbilirubinaria

7. PROCESSING OF CSF IN CYTOLOGY contd… PHYSICAL APPEREANCE

8. PROCESSING OF CSF IN CYTOLOGY contd… CYTOCENTRIFUGE TECHNIQUE Use of centrifugal force to direct specimen onto cytoslides 2 slides are made cause sample is in small quantity

9. PROCESSING OF CSF IN CYTOLOGY contd… 1-2 drops sample + 1-2 drops of alcohol (95%) Spin at 600 rpm for 5 mins Remove and fix in alcohol

10. PROCESSING OF CSF IN CYTOLOGY contd… STAINING TECHNIQUE OF CSF SLIDES STAINING Papanicolaou stain done Harris heamtoxylin (nuclear stain) OG-6 (cytoplasm satin ) EA 50 (immature cells) Heamtoxlyin Water Acid water Water Lithium carbonate 70% ehtyl alcohol 80%ethyl alcohol 95%ehtyl alcohol OG-6 EA 50 95% ethyl alcohol Xylene phenol Xylene Cover slip/ DPX

11. MICROSCOPIC EVALVATION OF SLIDES Normal CSF is essentially acellular Entire smear should be evaluated for abnormal cells inclusions within cells Clusters Presence of intracellular organism

12. MICROSCOPIC EVALVATION OF SLIDES Types of cells Lymphocytes & monocytes / macrophages Malignant cells Ependymal cells ( epithelial-like cells) Leukemia cells Neutrophils RBC WBC

13. DISEASED CONDITION OF CSF Meningeal infections viral,bacterial,fungal Clear to cloudy Subarachnoid hemorrhage ruptured cerebral aneurysm, or may result from head injury Bloody CSF CNS malignancy Brain tumors

14. DISEASED CONDITION OF CSF CONTD… Lymphocytes & monocytes / macrophages Mono / macro, segs and lymph

15. DISEASED CONDITION OF CSF CONTD… Ependymal cells Neutrophils

16. DISEASED CONDITION OF CSF CONTD… malignant cells Eosinophils

17. DISEASED CONDITION OF CSF CONTD… leukemic cells

18. PURPOSE OF CSF CYTOLOGY To confirm diagnosis of a disease Evaluate for intracranial hemorrhage Diagnose malignancies, leukemia Investigate central nervous system disorders

19. THANK YOU FOR YOUR PATIENCE  ANY QUESTIONS?