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Cerebrospinal Fluid

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Practical Cytopathology

Part of the book series: Practical Anatomic Pathology ((PAP))

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Abstract

Cytologic examination of cerebrospinal fluid (CSF) plays an integral role in the evaluation and prognosis of myriad conditions involving the central nervous system, including malignancy and infection. In this chapter, we address practical questions about CSF cytology preparation, cytologic analysis, and ancillary testing/workup with an emphasis on clinical correlation. This chapter, therefore, provides guidance not only for practicing cytopathologists and cytopathologists-in-training, but also for neurologists and neurologists-in-training.

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References

  1. Portela LA, Souza V, Pahl FH, et al. Laceration of the posterior inferior cerebellar artery by suboccipital puncture of the cisterna magna: case report. Arq Neuropsiquiatr. 2004;62(3B):882–4.

    Article  PubMed  Google Scholar 

  2. Chamberlain MC, Kormanik PA, Glantz MJ. A comparison between ventricular and lumbar cerebrospinal fluid cytology in adult patients with leptomeningeal metastases. Neuro-Oncology. 2001;3(1):42–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Gondos B, King EB. Cerebrospinal fluid cytology: diagnostic accuracy and comparison of different techniques. Acta Cytol. 1976;20(6):542–7.

    CAS  PubMed  Google Scholar 

  4. Nicol TL, Kelly D, Reynolds L, Rosenthal DL. Comparison of TriPath thin-layer technology with conventional methods on nongynecologic specimens. Acta Cytol. 2000;44(4):567–75.

    Article  CAS  PubMed  Google Scholar 

  5. Hoda RS. Non-gynecologic cytology on liquid-based preparations: a morphologic review of facts and artifacts. Diagn Cytopathol. 2007;35(10):621–34.

    Article  PubMed  Google Scholar 

  6. Pan Z, Yang G, Wang Y, et al. Thinprep plus Papanicolaou stain method is more sensitive than cytospin-coupled Wright Giems stain method in cerebrospinal fluid cytology for diagnosis of leptomeningeal metastasis from solid tumors. PLoS One. 2015;10(4):e0122016.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  7. Argon A, Uyaroğlu MA, Nart D, et al. The effectiveness of the liquid-based preparation method in cerebrospinal fluid cytology. Acta Cytol. 2013;57(3):266–70.

    Article  PubMed  Google Scholar 

  8. Guseo A. Classification of cells in the cerebrospinal fluid: a review. Eur Neurol. 1977;15(3):169–76.

    Article  CAS  PubMed  Google Scholar 

  9. Dyken PR. Cerebrospinal fluid cytology: practical clinical usefulness. Neurology. 1975;25(3):210–7.

    Article  CAS  PubMed  Google Scholar 

  10. Pappu LD, Purohit DM, Levkoff AH, Kaplan B. CSF cytology in the neonate. Am J Dis Child. 1982;136(4):297–8.

    CAS  PubMed  Google Scholar 

  11. de Reuck J, Vanderdonckt P. Choroid plexus and ependymal cells in CSF cytology. Clin Neurol Neurosurg. 1986;88(3):177–9.

    Article  PubMed  Google Scholar 

  12. Wilkins RH, Odom GL. Ependymal-choroidal cells in cerebrospinal fluid: increased incidence in hydrocephalic infants. J Neurosurg. 1974;41(5):555–60.

    Article  CAS  PubMed  Google Scholar 

  13. Del Bigio MR. Cell proliferation in human ganglionic eminence and suppression after prematurity-associated haemorrhage. Brain. 2011;134(Pt 5):1344–61.

    Article  PubMed  Google Scholar 

  14. Fernandes SP, Penchansky L. Tumorlike clusters of immature cells in cerebrospinal fluid of infants. Pediatr Pathol Lab Med. 1996;16(5):721–9.

    Article  CAS  PubMed  Google Scholar 

  15. Fischer JR, Davey DD, Gulley ML, Goeken JA. Blast-like cells in cerebrospinal fluid of neonates. Possible germinal matrix origin. Am J Clin Pathol. 1989;91(3):255–8.

    Article  CAS  PubMed  Google Scholar 

  16. Food and Drug Administration, HHS. Banned Devices; Powdered Surgeon’s Gloves, Powdered Patient Examination Gloves, and Absorbable Powder for Lubricating a Surgeon’s Glove. Final rule. Fed Regist. 2016;81(243):91722–31.

    Google Scholar 

  17. Oehmichen M, Schutze G. Erythrophagen in der Liquorzelldiagnostik der Subarachnoidalblutung. Nervenarzt. 1973;44:407.

    CAS  PubMed  Google Scholar 

  18. Buruma OJ, Janson HL, Den Bergh FA, Bots GT. Blood-stained cerebrospinal fluid: traumatic puncture or haemorrhage? J Neurol Neurosurg Psychiatry. 1981;44(2):144–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Veuger AJ, Kortbeek LH, Booij AC. Siderophages in differentiation of blood in cerebrospinal fluid. Clin Neurol Neurosurg. 1977;80(1):46–56.

    Article  CAS  PubMed  Google Scholar 

  20. Kortbeek LH, Booij AC. Bilirubin excess, erythrophages and siderophages in differentiation of blood in cerebrospinal fluid. Clin Neurol Neurosurg. 1979;81(4):265–79.

    Article  CAS  PubMed  Google Scholar 

  21. Choi HS, Anderson PJ. Diagnostic cytology of cerebrospinal fluid by the cytocentrifuge method. Am J Clin Pathol. 1979;72(6):931–43.

    Article  CAS  PubMed  Google Scholar 

  22. Herndon RM, Kasckow J. Electron microscopic studies of cerebrospinal fluid sediment in demyelinating disease. Ann Neurol. 1978;4(6):515–23.

    Article  CAS  PubMed  Google Scholar 

  23. Jadeja N, Nalleballe K, Graber J. Pearls & Oy-sters: plasma cell meningitis: an uncommon complication of multiple myeloma. Neurology. 2016;87(20):e240–2.

    Article  PubMed  Google Scholar 

  24. Hsia CC, Gob A. Cerebrospinal fluid plasmacytosis. Blood. 2012;120(15):2936.

    Article  PubMed  Google Scholar 

  25. Jordan M, Nagpal A, Newman W, et al. Plasma cell cerebrospinal fluid pleocytosis does not predict West Nile virus infection. J Biomed Biotechnol. 2012;2012:697418.

    Article  PubMed  Google Scholar 

  26. Thompson EJ, Kaufmann P, Shortman RC, et al. Oligoclonal immunoglobulins and plasma cells in spinal fluid of patients with multiple sclerosis. Br Med J. 1979;1(6155):16–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Zeman D, Adam P, Kalistová H, et al. Cerebrospinal fluid cytologic findings in multiple sclerosis. A comparison between patient subgroups. Acta Cytol. 2001;45(1):51–9.

    Article  CAS  PubMed  Google Scholar 

  28. Schluterman KO, Fassas AB, Van Hemert RL, Harik SI. Multiple myeloma invasion of the central nervous system. Arch Neurol. 2004;61(9):1423–9.

    Article  PubMed  Google Scholar 

  29. Kuberski T. Eosinophils in cerebrospinal fluid: criteria for eosinophilic meningitis. Hawaii Med J. 1981;40(4):97–8.

    CAS  PubMed  Google Scholar 

  30. Lo Re V 3rd, Gluckman SJ. Eosinophilic meningitis. Am J Med. 2003;114(3):217–23.

    Article  PubMed  Google Scholar 

  31. Graeff-Teixeira C, da Silva AC, Yoshimura K. Update on eosinophilic meningoencephalitis and its clinical relevance. Clin Microbiol Rev. 2009;22(2):322–48.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Kuberski T. Eosinophils in the cerebrospinal fluid. Ann Intern Med. 1979;91(1):70–5.

    Article  CAS  PubMed  Google Scholar 

  33. dos Reis JB, Mota I, Bei A, et al. Basophils of the cerebrospinal fluid. Arq Neuropsiquiatr. 1973;31(1):10–20.

    Article  PubMed  Google Scholar 

  34. Glasser L, Corrigan JJ Jr, Payne C. Basophilic meningitis secondary to lymphoma. Neurology. 1976;26(9):899–902.

    Article  CAS  PubMed  Google Scholar 

  35. Jaffe JP, Loprinzi CL. Basophilic-eosinophilic meningitis in an undifferentiated myeloproliferative disorder. JAMA. 1983;249(1):73–4.

    Article  CAS  PubMed  Google Scholar 

  36. Seehusen DA, Reeves MM, Fomin DA. Cerebrospinal fluid analysis. Am Fam Physician. 2003;68(6):1103–8.

    PubMed  Google Scholar 

  37. Ziai WC, Lewin JJ 3rd. Update in the diagnosis and management of central nervous system infections. Neurol Clin. 2008;26(2):427–68, viii.

    Article  PubMed  Google Scholar 

  38. Venkatesh B, Scott P, Ziegenfuss M. Cerebrospinal fluid in critical illness. Crit Care Resusc. 2000;2(1):42–54.

    CAS  PubMed  Google Scholar 

  39. DeMent SH, Cox MC, Gupta PK. Diagnosis of central nervous system Toxoplasma gondii from the cerebrospinal fluid in a patient with acquired immunodeficiency syndrome. Diagn Cytopathol. 1987;3(2):148–51.

    Article  CAS  PubMed  Google Scholar 

  40. Brogi E, Cibas ES. Cytologic detection of Toxoplasma gondii tachyzoites in cerebrospinal fluid. Am J Clin Pathol. 2000;114(6):951–5.

    Article  CAS  PubMed  Google Scholar 

  41. Prokesch RC, Rimland D, Petrini JL Jr, Fein AB. Cerebrospinal fluid pleocytosis after seizures. South Med J. 1983;76(3):322–7.

    Article  CAS  PubMed  Google Scholar 

  42. Sörnäs R, Ostlund H, Müller R. Cerebrospinal fluid cytology after stroke. Arch Neurol. 1972;26(6):489–501.

    Article  PubMed  Google Scholar 

  43. Danton GH, Dietrich WD. Inflammatory mechanisms after ischemia and stroke. J Neuropathol Exp Neurol. 2003;62(2):127–36.

    Article  CAS  PubMed  Google Scholar 

  44. Kupila L, Vuorinen T, Vainionpää R, et al. Etiology of aseptic meningitis and encephalitis in an adult population. Neurology. 2006;66(1):75–80.

    Article  CAS  PubMed  Google Scholar 

  45. Rotbart HA. Enteroviral infections of the central nervous system. Clin Infect Dis. 1995;20(4):971–81.

    Article  CAS  PubMed  Google Scholar 

  46. Lee BE, Davies HD. Aseptic meningitis. Curr Opin Infect Dis. 2007;20(3):272–7.

    Article  PubMed  Google Scholar 

  47. Irani DN. Aseptic meningitis and viral myelitis. Neurol Clin. 2008;26(3):635–55, vii–viii.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Kumar R. Aseptic meningitis: diagnosis and management. Indian J Pediatr. 2005;72(1):57–63.

    Article  PubMed  Google Scholar 

  49. Jolles S, Sewell WA, Leighton C. Drug-induced aseptic meningitis: diagnosis and management. Drug Saf. 2000;22(3):215–26.

    Article  CAS  PubMed  Google Scholar 

  50. Negrini B, Kelleher KJ, Wald ER. Cerebrospinal fluid findings in aseptic versus bacterial meningitis. Pediatrics. 2000;105(2):316–9.

    Article  CAS  PubMed  Google Scholar 

  51. Ross JS, Magro C, Szyfelbein W, Sorensen S. Cerebrospinal fluid pleocytosis in aseptic meningitis: cytomorphic and immunocytochemical features. Diagn Cytopathol. 1991;7(5):532–5.

    Article  CAS  PubMed  Google Scholar 

  52. Rubin SJ. Detection of viruses in spinal fluid. Am J Med. 1983;75(1B):124–8.

    Article  CAS  PubMed  Google Scholar 

  53. Nakhleh RE, Myers JL, Allen TC, et al. Consensus statement on effective communication of urgent diagnoses and significant, unexpected diagnoses in surgical pathology and cytopathology from the College of American Pathologists and Association of Directors of Anatomic and Surgical Pathology. Arch Pathol Lab Med. 2012;136(2):148–54.

    Article  PubMed  Google Scholar 

  54. Pereira TC, Silverman JF, LiVolsi V, et al. A multi-institutional survey of critical diagnoses (critical values) in surgical pathology and cytology. Am J Clin Pathol. 2008;130(5):731–5.

    Article  PubMed  Google Scholar 

  55. Pereira TC, Clayton AC, Tazelaar HD, et al. Critical values in cytology. Diagn Cytopathol. 2006;34(6):447–51.

    Article  PubMed  Google Scholar 

  56. He T, Kaplan S, Kamboj M, Tang YW. Laboratory diagnosis of central nervous system infection. Curr Infect Dis Rep. 2016;18(11):35.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004;39(9):1267–84.

    Article  PubMed  Google Scholar 

  58. Karre T, Vetter EA, Mandrekar JN, Patel R. Comparison of bacterial antigen test and gram stain for detecting classic meningitis bacteria in cerebrospinal fluid. J Clin Microbiol. 2010;48(4):1504–5.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Saravolatz LD, Manzor O, VanderVelde N, et al. Broad-range bacterial polymerase chain reaction for early detection of bacterial meningitis. Clin Infect Dis. 2003;36(1):40–5.

    Article  CAS  PubMed  Google Scholar 

  60. Welinder-Olsson C, Dotevall L, Hogevik H, et al. Comparison of broad-range bacterial PCR and culture of cerebrospinal fluid for diagnosis of community-acquired bacterial meningitis. Clin Microbiol Infect. 2007;13(9):879–86.

    Article  CAS  PubMed  Google Scholar 

  61. Debiasi RL, Tyler KL. Molecular methods for diagnosis of viral encephalitis. Clin Microbiol Rev. 2004;17(4):903–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Hodinka RL. Point: is the era of viral culture over in the clinical microbiology laboratory? J Clin Microbiol. 2013;51(1):2–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Polage CR, Petti CA. Assessment of the utility of viral culture of cerebrospinal fluid. Clin Infect Dis. 2006;43(12):1578–9.

    Article  PubMed  Google Scholar 

  64. Davis LE, Beckham JD, Tyler KL. North American encephalitic arboviruses. Neurol Clin. 2008;26(3):727–57.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Barenfanger J, Lawhorn J, Drake C. Nonvalue of culturing cerebrospinal fluid for fungi. J Clin Microbiol. 2004;42(1):236–8.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Frank UK, Nishimura SL, Li NC, et al. Evaluation of an enzyme immunoassay for detection of cryptococcal capsular polysaccharide antigen in serum and cerebrospinal fluid. J Clin Microbiol. 1993;31(1):97–101.

    CAS  PubMed  PubMed Central  Google Scholar 

  67. Chuck SL, Sande MA. Infections with Cryptococcus neoformans in the acquired immunodeficiency syndrome. N Engl J Med. 1989;321(12):794–9.

    Article  CAS  PubMed  Google Scholar 

  68. Binnicker MJ, Jespersen DJ, Bestrom JE, Rollins LO. Comparison of four assays for the detection of cryptococcal antigen. Clin Vaccine Immunol. 2012;19(12):1988–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Chamberlain MC. Leptomeningeal metastasis. Curr Opin Oncol. 2010;22(6):627–35.

    Article  PubMed  Google Scholar 

  70. Weston CL, Glantz MJ, Connor JR. Detection of cancer cells in the cerebrospinal fluid: current methods and future directions. Fluids Barriers CNS. 2011;8(1):14.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Mammoser AG, Groves MD. Biology and therapy of neoplastic meningitis. Curr Oncol Rep. 2010;12(1):41–9.

    Article  PubMed  Google Scholar 

  72. Le Rhun E, Taillibert S, Chamberlain MC. Carcinomatous meningitis: leptomeningeal metastases in solid tumors. Surg Neurol Int. 2013;4(Suppl 4):S265–88.

    PubMed  PubMed Central  Google Scholar 

  73. Glantz MJ, Cole BF, Glantz LK, et al. Cerebrospinal fluid cytology in patients with cancer: minimizing false-negative results. Cancer. 1998;82(4):733–9.

    Article  CAS  PubMed  Google Scholar 

  74. Straathof CS, de Bruin HG, Dippel DW, Vecht CJ. The diagnostic accuracy of magnetic resonance imaging and cerebrospinal fluid cytology in leptomeningeal metastasis. J Neurol. 1999;246(9):810–4.

    Article  CAS  PubMed  Google Scholar 

  75. Hegde U, Filie A, Little RF, et al. High incidence of occult leptomeningeal disease detected by flow cytometry in newly diagnosed aggressive B-cell lymphomas at risk for central nervous system involvement: the role of flow cytometry versus cytology. Blood. 2005;105(2):496–502.

    Article  CAS  PubMed  Google Scholar 

  76. Quijano S, López A, Manuel Sancho J, et al. Identification of leptomeningeal disease in aggressive B-cell non-Hodgkin's lymphoma: improved sensitivity of flow cytometry. J Clin Oncol. 2009;27(9):1462–9.

    Article  CAS  PubMed  Google Scholar 

  77. Bromberg JE, Breems DA, Kraan J, et al. CSF flow cytometry greatly improves diagnostic accuracy in CNS hematologic malignancies. Neurology. 2007;68(20):1674–9.

    Article  CAS  PubMed  Google Scholar 

  78. Hovestadt A, Henzen-Logmans SC, Vecht CJ. Immunohistochemical analysis of the cerebrospinal fluid for carcinomatous and lymphomatous leptomeningitis. Br J Cancer. 1990;62(4):653–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  79. Pentsova EI, Shah RH, Tang J, et al. Evaluating cancer of the central nervous system through next-generation sequencing of cerebrospinal fluid. J Clin Oncol. 2016;34(20):2404–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  80. Cristofanilli M, Budd GT, Ellis MJ, et al. Circulating tumor cells, disease progression, and survival in metastatic breast cancer. N Engl J Med. 2004;351(8):781–91.

    Article  CAS  PubMed  Google Scholar 

  81. Pierga JY, Bidard FC, Mathiot C, et al. Circulating tumor cell detection predicts early metastatic relapse after neoadjuvant chemotherapy in large operable and locally advanced breast cancer in a phase II randomized trial. Clin Cancer Res. 2008;14(21):7004–10.

    Article  CAS  PubMed  Google Scholar 

  82. Nayak L, Fleisher M, Gonzalez-Espinoza R, et al. Rare cell capture technology for the diagnosis of leptomeningeal metastasis in solid tumors. Neurology. 2013;80(17):1598–605.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Tu Q, Wu X, Le Rhun E, et al. CellSearch technology applied to the detection and quantification of tumor cells in CSF of patients with lung cancer leptomeningeal metastasis. Lung Cancer. 2015;90(2):352–7.

    Article  PubMed  Google Scholar 

  84. Olson ME, Chernik NL, Posner JB. Infiltration of the leptomeninges by systemic cancer. A clinical and pathologic study. Arch Neurol. 1974;30(2):122–37.

    Article  CAS  PubMed  Google Scholar 

  85. Wasserstrom WR, Glass JP, Posner JB. Diagnosis and treatment of leptomeningeal metastases from solid tumors: experience with 90 patients. Cancer. 1982;49(4):759–72.

    Article  CAS  PubMed  Google Scholar 

  86. Niwińska A, Rudnicka H, Murawska M. Breast cancer leptomeningeal metastasis: propensity of breast cancer subtypes for leptomeninges and the analysis of factors influencing survival. Med Oncol. 2013;30(1):408.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Lamovec J, Zidar A. Association of leptomeningeal carcinomatosis in carcinoma of the breast with infiltrating lobular carcinoma. An autopsy study. Arch Pathol Lab Med. 1991;115(5):507–10.

    CAS  PubMed  Google Scholar 

  88. Scott BJ, Kesari S. Leptomeningeal metastases in breast cancer. Am J Cancer Res. 2013;3(2):117–26.

    CAS  PubMed  PubMed Central  Google Scholar 

  89. Morris PG, Reiner AS, Szenberg OR, et al. Leptomeningeal metastasis from non-small cell lung cancer: survival and the impact of whole brain radiotherapy. J Thorac Oncol. 2012;7(2):382–5.

    Article  PubMed  Google Scholar 

  90. Bullard DE, Cox EB, Seigler HF. Central nervous system metastases in malignant melanoma. Neurosurgery. 1981;8(1):26–30.

    Article  CAS  PubMed  Google Scholar 

  91. Gleissner B, Chamberlain MC. Neoplastic meningitis. Lancet Neurol. 2006;5(5):443–52.

    Article  PubMed  Google Scholar 

  92. Ringenberg QS, Francis R, Doll DC. Meningeal carcinomatosis as the presenting manifestation of tumors of unknown origin. Acta Cytol. 1990;34(4):590–2.

    CAS  PubMed  Google Scholar 

  93. Seute T, Leffers P, ten Velde GP, Twijnstra A. Leptomeningeal metastases from small cell lung carcinoma. Cancer. 2005;104(8):1700–5.

    Article  PubMed  Google Scholar 

  94. Lee JL, Kang YK, Kim TW, et al. Leptomeningeal carcinomatosis in gastric cancer. J Neuro-Oncol. 2004;66(1–2):167–74.

    Article  Google Scholar 

  95. Pape E, Desmedt E, Zairi F, et al. Leptomeningeal metastasis in melanoma: a prospective clinical study of nine patients. In Vivo. 2012;26(6):1079–86.

    PubMed  Google Scholar 

  96. Oh SY, Lee SJ, Lee J, et al. Gastric leptomeningeal carcinomatosis: multi-center retrospective analysis of 54 cases. World J Gastroenterol. 2009;15(40):5086–90.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Dolecek TA, Propp JM, Stroup NE, Kruchko C. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005-2009. Neuro-Oncology. 2012;14 Suppl 5:v1–49.

    Article  PubMed  Google Scholar 

  98. Schmitz N, Wu HS. Advances in the treatment of secondary CNS lymphoma. J Clin Oncol. 2015;33(33):3851–3.

    Article  CAS  PubMed  Google Scholar 

  99. Friedberg JW. How I treat double-hit lymphoma. Blood. 2017;130(5):590–6.

    Article  CAS  PubMed  Google Scholar 

  100. Savage KJ, Slack GW, Mottok A, et al. Impact of dual expression of MYC and BCL2 by immunohistochemistry on the risk of CNS relapse in DLBCL. Blood. 2016;127(18):2182–8.

    Article  CAS  PubMed  Google Scholar 

  101. Petrich AM, Gandhi M, Jovanovic B, et al. Impact of induction regimen and stem cell transplantation on outcomes in double-hit lymphoma: a multicenter retrospective analysis. Blood. 2014;124(15):2354–61.

    Article  CAS  PubMed  Google Scholar 

  102. Hu S, Xu-Monette ZY, Tzankov A, et al. MYC/BCL2 protein coexpression contributes to the inferior survival of activated B-cell subtype of diffuse large B-cell lymphoma and demonstrates high-risk gene expression signatures: a report from the international DLBCL rituximab-CHOP consortium program. Blood. 2013;121(20):4021–31; quiz 4250.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  103. Elkins CT, Wakely PE Jr. Cytopathology of “double-hit” non-Hodgkin lymphoma. Cancer Cytopathol. 2011;119(4):263–71.

    Article  PubMed  Google Scholar 

  104. Kantarjian HM, O'Brien S, Smith TL, et al. Results of treatment with hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol. 2000;18(3):547–61.

    Article  CAS  PubMed  Google Scholar 

  105. Cortes J, O'Brien SM, Pierce S, et al. The value of high-dose systemic chemotherapy and intrathecal therapy for central nervous system prophylaxis in different risk groups of adult acute lymphoblastic leukemia. Blood. 1995;86(6):2091–7.

    Article  CAS  PubMed  Google Scholar 

  106. Matloub Y, Lindemulder S, Gaynon PS, et al. Intrathecal triple therapy decreases central nervous system relapse but fails to improve event-free survival when compared with intrathecal methotrexate: results of the Children’s Cancer Group (CCG) 1952 study for standard-risk acute lymphoblastic leukemia, reported by the Children’s Oncology Group. Blood. 2006;108(4):1165–73.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  107. Lazarus HM, Richards SM, Chopra R, et al. Central nervous system involvement in adult acute lymphoblastic leukemia at diagnosis: results from the international ALL trial MRC UKALL XII/ECOG E2993. Blood. 2006;108(2):465–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  108. Murthy H, Anasetti C, Ayala E. Diagnosis and management of leukemic and lymphomatous meningitis. Cancer Control. 2017;24(1):33–41.

    Article  PubMed  Google Scholar 

  109. Packer RJ, Siegel KR, Sutton LN, et al. Leptomeningeal dissemination of primary central nervous system tumors of childhood. Ann Neurol. 1985;18(2):217–21.

    Article  CAS  PubMed  Google Scholar 

  110. Terterov S, Krieger MD, Bowen I, McComb JG. Evaluation of intracranial cerebrospinal fluid cytology in staging pediatric medulloblastomas, supratentorial primitive neuroectodermal tumors, and ependymomas. J Neurosurg Pediatr. 2010;6(2):131–6.

    Article  PubMed  Google Scholar 

  111. Meyers SP, Wildenhain SL, Chang JK, et al. Postoperative evaluation for disseminated medulloblastoma involving the spine: contrast-enhanced MR findings, CSF cytologic analysis, timing of disease occurrence, and patient outcomes. AJNR Am J Neuroradiol. 2000;21(9):1757–65.

    CAS  PubMed  PubMed Central  Google Scholar 

  112. Miralbell R, Bieri S, Huguenin P, et al. Prognostic value of cerebrospinal fluid cytology in pediatric medulloblastoma. Swiss Pediatric Oncology Group. Ann Oncol. 1999;10(2):239–41.

    Article  CAS  PubMed  Google Scholar 

  113. Cohen NR, Phipps K, Harding B, Jacques TS. Is CSF cytology a useful diagnostic procedure in staging paediatric CNS tumours? Cytopathology. 2009;20(4):256–60.

    Article  CAS  PubMed  Google Scholar 

  114. Fangusaro J, Van Den Berghe C, et al. Evaluating the incidence and utility of microscopic metastatic dissemination as diagnosed by lumbar cerebro-spinal fluid (CSF) samples in children with newly diagnosed intracranial ependymoma. J Neuro-Oncol. 2011;103(3):693–8.

    Article  Google Scholar 

  115. Poltinnikov IM, Merchant TE. CSF cytology has limited value in the evaluation of patients with ependymoma who have MRI evidence of metastasis. Pediatr Blood Cancer. 2006;47(2):169–73.

    Article  PubMed  Google Scholar 

  116. Chowdhary S, Damlo S, Chamberlain MC. Cerebrospinal fluid dissemination and neoplastic meningitis in primary brain tumors. Cancer Control. 2017;24(1):S1–S16.

    Article  PubMed  Google Scholar 

  117. Moreno L, Pollack IF, Duffner PK, et al. Utility of cerebrospinal fluid cytology in newly diagnosed childhood ependymoma. J Pediatr Hematol Oncol. 2010;32(6):515–8.

    Article  PubMed  Google Scholar 

  118. Qian X, Goumnerova LC, De Girolami U, Cibas ES. Cerebrospinal fluid cytology in patients with ependymoma: a bi-institutional retrospective study. Cancer. 2008;114(5):307–14.

    Article  PubMed  Google Scholar 

  119. Biswas A, Kashyap L, Kakkar A, et al. Atypical teratoid/rhabdoid tumors: challenges and search for solutions. Cancer Manag Res. 2016;8:115–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  120. Rorke LB, Packer RJ, Biegel JA. Central nervous system atypical teratoid/rhabdoid tumors of infancy and childhood: definition of an entity. J Neurosurg. 1996;85(1):56–65.

    Article  CAS  PubMed  Google Scholar 

  121. Athale UH, Duckworth J, Odame I, Barr R. Childhood atypical teratoid rhabdoid tumor of the central nervous system: a meta-analysis of observational studies. J Pediatr Hematol Oncol. 2009;31(9):651–63.

    Article  PubMed  Google Scholar 

  122. Dufour C, Beaugrand A, Le Deley MC, et al. Clinicopathologic prognostic factors in childhood atypical teratoid and rhabdoid tumor of the central nervous system: a multicenter study. Cancer. 2012;118(15):3812–21.

    Article  PubMed  Google Scholar 

  123. von Hoff K, Hinkes B, Dannenmann-Stern E, et al. Frequency, risk-factors and survival of children with atypical teratoid rhabdoid tumors (AT/RT) of the CNS diagnosed between 1988 and 2004, and registered to the German HIT database. Pediatr Blood Cancer. 2011;57(6):978–85.

    Article  Google Scholar 

  124. Ho CY, VandenBussche CJ, Huppman AR, et al. Cytomorphologic and clinicoradiologic analysis of primary nonhematologic central nervous system tumors with positive cerebrospinal fluid. Cancer Cytopathol. 2015;123(2):123–35.

    Article  PubMed  Google Scholar 

  125. Huang EC, Guzman MA, De Girolami U, Cibas ES. Cytologic characterization of atypical teratoid/rhabdoid tumor in cerebrospinal fluid. Cancer Cytopathol. 2014;122(12):903–8.

    Article  PubMed  Google Scholar 

  126. Kun LE, D'Souza B, Tefft M. The value of surveillance testing in childhood brain tumors. Cancer. 1985;56(7 Suppl):1818–23.

    Article  CAS  PubMed  Google Scholar 

  127. Kramer ED, Vezina LG, Packer RJ, et al. Staging and surveillance of children with central nervous system neoplasms: recommendations of the Neurology and Tumor Imaging Committees of the Children’s Cancer Group. Pediatr Neurosurg. 1994;20(4):254–62. discussion 262-3

    Article  CAS  PubMed  Google Scholar 

  128. Abrey LE, Batchelor TT, Ferreri AJ, et al. Report of an international workshop to standardize baseline evaluation and response criteria for primary CNS lymphoma. J Clin Oncol. 2005;23(22):5034–43.

    Article  PubMed  Google Scholar 

  129. George SL, Ochs JJ, Mauer AM, Simone JV. The importance of an isolated central nervous system relapse in children with acute lymphoblastic leukemia. J Clin Oncol. 1985;3(6):776–81.

    Article  CAS  PubMed  Google Scholar 

  130. Gassas A, Krueger J, Alvi S, et al. Diagnosis of central nervous system relapse of pediatric acute lymphoblastic leukemia: impact of routine cytological CSF analysis at the time of intrathecal chemotherapy. Pediatr Blood Cancer. 2014;61(12):2215–7.

    Article  PubMed  Google Scholar 

  131. Huang L, Lequin M, Pieters R, van den Heuvel-Eibrink MM. The clinical value of follow-up examinations in childhood T-cell acute lymphoblastic leukemia and T-cell non-Hodgkin’s lymphoma. Pediatr Blood Cancer. 2007;48(4):468–72.

    Article  CAS  PubMed  Google Scholar 

  132. Levinson A, Arnold S, Jin Z, et al. Timing and utility of relapse surveillance after allogeneic hematopoietic cell transplantation in children with leukemia. Biol Blood Marrow Transplant. 2017;23(4):696–700.

    Article  PubMed  Google Scholar 

  133. Hutt PJ, Sabio H, Gilchrist GS, O'Brien C. Childhood acute lymphoblastic leukemia: are routine end-of-therapy bone marrow and cerebrospinal fluid examinations necessary? Mayo Clin Proc. 1996;71(9):854–6.

    Article  CAS  PubMed  Google Scholar 

  134. Biasotti S, Garaventa A, Padovani P, et al. Role of active follow-up for early diagnosis of relapse after elective end of therapies. Pediatr Blood Cancer. 2005;45(6):781–6.

    Article  PubMed  Google Scholar 

  135. Jorgensen M, Shankar A, Aabideen Z, et al. The role of routine surveillance for silent central nervous system relapse in children with acute lymphoblastic leukaemia. Br J Haematol. 2012;159(3):368–70.

    Article  PubMed  Google Scholar 

  136. Dalmau J, Rosenfeld MR. Paraneoplastic syndromes of the CNS. Lancet Neurol. 2008;7(4):327–40.

    Article  PubMed  PubMed Central  Google Scholar 

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  1. Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA

    Matthew Torre

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    Huihong Xu

  2. Brigham and Women’s Hospital, Boston, MA, USA

    Xiaohua Qian

  3. Robert Wood Johnson University Hospital, New Brunswick, NJ, USA

    He Wang

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Torre, M. (2020). Cerebrospinal Fluid. In: Xu, H., Qian, X., Wang, H. (eds) Practical Cytopathology . Practical Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-24059-2_10

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