Cerebrospinal fluid data. 2. Interpretation in intracranial malignancy and multiple sclerosis

In malignancies involving the CNS, notably leukemia, malignant cells may be readily demonstrated in the CSF, directly confirming the diagnosis. Advances in cell isolation techniques have significantly increased the diagnostic yield of CSF cytology. A variety of CSF protein studies and both WBC and differential counts are central to the diagnosis of multiple sclerosis. Protein studies include total protein levels, gamma globulin levels, and electrophoretic techniques designed to demonstrate the fine structure of gamma globulin, ie, its separation into two to ten (or more) oligoclonal bands. Although by no means specific for multiple sclerosis, such bands are strongly supportive of the diagnosis in the correct clinical setting.