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

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

3. Proteins
Glucose
Cholesterol
Na+
Ca+
Urea
Creatinine
Lactic acid

4. Lumbar puncture or spinal tap

5. Check Physical Appearance (gross)
Slide Making (cytocentrifuge technique)
Staining of slides
Microscopic evaluation of slides

6. 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.  PHYSICAL APPEREANCE

8. CYTOCENTRIFUGE TECHNIQUE
 Use of centrifugal force to direct specimen onto cytoslides
 2 slides are made cause sample is in small quantity

9.  1-2 drops sample + 1-2 drops of alcohol (95%)
 Spin at 600 rpm for 5 mins
 Remove and fix in alcohol

10. 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. Normal CSF is essentially acellular
Entire smear should be evaluated for
• abnormal cells
• inclusions within cells
• Clusters
• Presence of intracellular organism

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

13. 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. Lymphocytes & monocytes /
macrophages
Mono / macro, segs and lymph

15. Ependymal cells
Neutrophils

16. malignant cells Eosinophils

17. leukemic cells

18. • 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?