PMC3814656_01
Cerebrospinal fluid containing bone marrow elements including promyelocyte, myelocyte, metamyelocyte and nucleated red blood cells
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F1
The specimen contains myeloid and erythroid precursors at various stages of maturation together with occasional lymphocytes and monocytes [Figure 1]. Myeloid precursors such as promyelocyte, myelocyte and metamyelocyte are seen in Figure 1.
Mixed inflammation showing small numbers of lymphocytes and neutrophils
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F2
A cytological picture of predominantly polymorphonuclear leukocytes may indicate non-specific mixed inflammation [Figure 2], bacterial meningitis [Figure 3], cerebral abscess and empyema, CNS hemorrhage and infarction or occasionally the early stages of viral and fungal infection.
Neutrophilia together with small numbers of normal and activated lymphocytes
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F3
A cytological picture of predominantly polymorphonuclear leukocytes may indicate non-specific mixed inflammation [Figure 2], bacterial meningitis [Figure 3], cerebral abscess and empyema, CNS hemorrhage and infarction or occasionally the early stages of viral and fungal infection.
Malignant cells of metastatic squamous cell carcinoma surrounded by polymorphous inflammation
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F4
Immune response caused by malignant processes may present a similar picture [Figure 4].
Viral meningitis showing normal and activated lymphocytes with and scattered macrophages
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F5
Other infective differential diagnoses include mycobacterial tuberculosis and viral meningoencephalitis in which the CSF contains predominantly lymphocytes and monocytes [Figure 5].
Acute lymphoblastic leukemia containing numerous lymphoblasts
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F6
The presence of myeloid and lymphoid precursors may suggest CNS involvement by acute leukemia [Figure 6], lymphoma [Figure 7] or contamination by peripheral blood with abnormal blasts [Figure 8].
Abnormal blasts in B-cell non-Hodgkin's lymphoma
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F7
The presence of myeloid and lymphoid precursors may suggest CNS involvement by acute leukemia [Figure 6], lymphoma [Figure 7] or contamination by peripheral blood with abnormal blasts [Figure 8].
Contaminant peripheral blood containing abnormal blasts
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F8
The presence of myeloid and lymphoid precursors may suggest CNS involvement by acute leukemia [Figure 6], lymphoma [Figure 7] or contamination by peripheral blood with abnormal blasts [Figure 8].
Traumatic tap showing numerous red blood cells with scattered neutrophils and lymphocytes consistent with peripheral blood
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F9
Increased numbers of red blood cells may also result in misdiagnosis of a traumatic tap [Figure 9].