This presentation discusses the cytology of cerebrospinal fluid (CSF). CSF is normally clear, colorless, and transparent. It is produced in the cerebral ventricles and circulates in the spinal canal. A lumbar puncture or spinal tap is performed to examine the physical appearance and microscopic evaluation of CSF slides. The cytology technique involves centrifuging CSF samples onto slides, staining with Papanicolaou stain, and examining under a microscope. Normal CSF is acellular, while abnormal CSF may contain lymphocytes, monocytes, malignant or leukemia cells, indicating conditions such as meningitis, subarachnoid hemorrhage, or CNS malignancy. Cytology of CSF aids in the diagnosis of various

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?