TY - JOUR
T1 - Cytomorphologic Features Found in Cerebrospinal Fluid Specimens of Hemophagocytic Lymphohistiocytosis Patients
AU - Shyu, Susan
AU - Luca, Dragos
AU - Vandenbussche, Christopher J.
AU - Ho, Cheng Ying
N1 - Publisher Copyright:
© 2021 American Society for Clinical Pathology,. All rights reserved.
PY - 2021/9/1
Y1 - 2021/9/1
N2 - Objectives: Central nervous system involvement is present in 70% of patients with hemophagocytic lymphohistiocytosis (CNS-HLH). CNS-HLH is defined by neurologic deficits, neuroimaging abnormalities, or positive cerebrospinal fluid (CSF) findings. The CSF cytomorphologic spectrum of CNS-HLH, however, has not been well investigated. Methods: A retrospective review was performed on 64 CSF specimens from pediatric and adult patients with HLH. Ten patients had clinicoradiologic evidence of CNS involvement. Results: We identified five CSF cytomorphologic patterns: (1) hemophagocytosis, (2) vacuolated macrophages without evidence of hemophagocytosis, (3) monocytes and/or nonvacuolated macrophages, (4) acellular specimens, and (5) bloody specimens. Patterns 1 and 2 were common in CNS-HLH and rare in patients without CNS involvement. The CSF cytomorphologic patterns did not correlate well with WBC counts or protein concentration. Conclusions: Our study offers a comprehensive view of the cytomorphologic features seen in CSF specimens from patients with HLH.
AB - Objectives: Central nervous system involvement is present in 70% of patients with hemophagocytic lymphohistiocytosis (CNS-HLH). CNS-HLH is defined by neurologic deficits, neuroimaging abnormalities, or positive cerebrospinal fluid (CSF) findings. The CSF cytomorphologic spectrum of CNS-HLH, however, has not been well investigated. Methods: A retrospective review was performed on 64 CSF specimens from pediatric and adult patients with HLH. Ten patients had clinicoradiologic evidence of CNS involvement. Results: We identified five CSF cytomorphologic patterns: (1) hemophagocytosis, (2) vacuolated macrophages without evidence of hemophagocytosis, (3) monocytes and/or nonvacuolated macrophages, (4) acellular specimens, and (5) bloody specimens. Patterns 1 and 2 were common in CNS-HLH and rare in patients without CNS involvement. The CSF cytomorphologic patterns did not correlate well with WBC counts or protein concentration. Conclusions: Our study offers a comprehensive view of the cytomorphologic features seen in CSF specimens from patients with HLH.
KW - Cerebrospinal fluid
KW - Cytology
KW - Hemophagocytic lymphohistiocytosis
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U2 - 10.1093/ajcp/aqaa248
DO - 10.1093/ajcp/aqaa248
M3 - Article
C2 - 33624013
AN - SCOPUS:85114055641
SN - 0002-9173
VL - 156
SP - 381
EP - 390
JO - American journal of clinical pathology
JF - American journal of clinical pathology
IS - 3
ER -