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Am J Clin Pathol. 2014 Apr;141(4):515-21. doi: 10.1309/AJCP8IB8FRQDVPXL.
To identify pretest characteristics of cerebrospinal fluid (CSF) specimens that will allow the rational use of flow cytometric analysis (FCA) in the diagnosis of hematologic malignancy.
Retrospective data were collected on 501 consecutive CSF samples submitted for FCA.
A positive diagnosis of hematologic malignancy was made in 41 specimens (8.2%). Blasts or atypical lymphocytes were noted on Wright-stained slides in 98% of FCA-positive specimens (40/41), and a history of a hematologic malignancy was present in 89% of specimens (34/38). All FCA-positive specimens had atypical morphology or history of hematologic malignancy. Four hundred six specimens (81%) were FCA negative. Of FCA-negative specimens, 7% (30/406) had atypical morphology, and 3% (12/404) had future central nervous system involvement seen within 30 days.
These data support a policy in which FCA of CSF is actively discouraged unless atypical lymphocytes or blasts are seen or a history of hematologic malignancy is present.
确定脑脊液（CSF）标本的预测特征，以便在诊断血液恶性肿瘤时合理使用流式细胞术分析（FCA）。
对 501 例连续提交进行 FCA 的 CSF 样本进行了回顾性数据分析。
41 份标本（8.2%）确诊为血液恶性肿瘤。在 98%的 FCA 阳性标本（40/41）中，Wright 染色载玻片上可见原始细胞或异型淋巴细胞，89%的标本（34/38）有血液恶性肿瘤病史。所有 FCA 阳性标本均具有异型形态或血液恶性肿瘤病史。406 份标本（81%）FCA 阴性。在 FCA 阴性标本中，7%（30/406）有异型形态，3%（12/404）在 30 天内出现中枢神经系统受累。
这些数据支持这样一种策略，即除非看到异型淋巴细胞或原始细胞，或存在血液恶性肿瘤病史，否则应积极避免 CSF 的 FCA。
