Flow cytometric immunophenotyping of cerebrospinal fluid specimens
Fiona E Craig1, N Paul Ohori, Timothy S Gorrill
1Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
American Journal of Clinical Pathology
|December 22, 2010
Summary
Flow cytometric immunophenotyping (FCI) aids in diagnosing hematologic neoplasms in cerebrospinal fluid (CSF). While valuable, especially in low-cellularity samples, FCI results require careful interpretation due to potential artifacts and indeterminate findings.
Area of Science:
- Hematology
- Immunology
- Neurology
Background:
- Flow cytometric immunophenotyping (FCI) is crucial for diagnosing hematologic neoplasms in cerebrospinal fluid (CSF).
- Evaluating CSF for malignancy is essential for patient management and treatment decisions.
Purpose of the Study:
- To assess the diagnostic utility and challenges of FCI in CSF specimens.
- To determine the positivity and indeterminate rates of FCI in CSF analysis.
Main Methods:
- Retrospective review of 230 CSF specimens analyzed by FCI.
- Specimens were categorized into primary diagnosis (n=77) and follow-up (n=153).
- Analysis included evaluation of cellularity, event counts, staining quality, and phenotypic findings.
Main Results:
- FCI was positive in 4.8% (11/230) of specimens, identifying acute myeloid leukemia, B-acute lymphoblastic leukemia, and B/T-cell lymphomas.
- Positive results were observed even in low-cellularity samples.
- FCI yielded indeterminate results in 8.3% (19/230) of cases, often due to low cellularity, artifacts, or insufficient phenotypic data.
Conclusions:
- FCI is a valuable tool for detecting hematologic neoplasms in CSF, including challenging low-cellularity specimens.
- Interpretation of FCI results requires caution due to indeterminate findings and potential artifacts.
- Further optimization may be needed to improve diagnostic accuracy in limited CSF samples.
