Objectives: Cytological examination of cerebrospinal fluid (CSF) is a routine procedure in the management of patients with malignancies that frequently spread via leptomeninges. Interpretation, understanding and cytological characteristics of these lesions are required. Detection of malignant cells in cerebrospinal fluid in cytology is the diagnostic gold standard for leptomeningeal carcinomatosis (LC).
Material and Method: Retrospective analysis of 5394 cases of CSF was done over 5 years duration at cancer hospital. Smears were stained with papanicolaou stain and examined. Data were analyzed with clinical detailed.
Results: Patient`s age ranged from 1 to 70 years. Out of 5394, 273 cases were positive for malignant cells, and 4 cases had infectious etiology. Acute lymphoblastic leukemia was the commonest malignancy infiltrating CSF in both, followed by retinoblastoma, nonhodgkins lymphoma in pediatric and nonhodgkins lymphoma and metastatic carcinoma in adults. Other rare tumor infiltrating CSF found in our study were myeloid leukemia, medulloblastoma, peripheral neuroectodermal tumor, and space occupying lesion of brain, where primary could not found. Of four infectious cases, one case of Cryptococcus meningitis was found.
Conclusion: Correct identification of LC is important as it as therapeutic and prognostic implications. Thus, cytological examinations of the CSF played a decisive role in the diagnosis of LC.
Key Words: Cerebrospinal fluid;Cytology;Meningitis;Cancer;CSF