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

Area of Science:

• Neuroimmunology
• Cytopathology

Background:

• Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
• Understanding the specific cytologic features within cerebrospinal fluid (CSF) can provide valuable insights into MS pathogenesis and disease progression.

Purpose of the Study:

• To compare cytologic findings in the cerebrospinal fluid (CSF) of various multiple sclerosis (MS) patient subgroups.
• To evaluate the utility of qualitative CSF cytology in understanding MS.

Main Methods:

• Qualitative cytology analysis of CSF from 77 patients with definitive or probable MS.
• Cell counts, differential counts, lymphocyte/monocyte ratio, activated cell percentages, lymphoplasmacytes, plasma cells, lipophages, lymphophages, and mitotic figures were assessed.
• Special stains including May-Grünwald-Giemsa, oil red O, Papanicolaou, and toluidine blue were utilized.

Main Results:

• Primary progressive MS showed a higher prevalence of mitotic figures.
• More disabled patients had increased foam cells and lymphophages, with lower CSF pleocytosis.
• Treated patients exhibited lower cell counts, reduced CSF pleocytosis, a lower lymphocyte/monocyte ratio, and fewer lymphoplasmacytes.
• Longer disease duration correlated with a higher prevalence of mature plasma cells and lipophages.

Conclusions:

• Observed CSF cytologic differences among MS subgroups may reflect distinct pathogenic mechanisms.
• Qualitative CSF cytology is a valuable diagnostic tool for clinicians and neuroimmunologists in managing MS.
• CSF cytology should be an integral part of the examination for all MS patients.