Jeren T, Beus I
Acta Cytol. 1982 Sep-Oct;26(5):678-80.
A retrospective study of 84 cases of tuberculous meningitis from a ten-year period is presented. Lumbar punctures had been performed, and the dynamics of cytologic changes in the cerebrospinal fluid (CSF) had been followed weekly during the course of the disease. The typical clinical picture, the course of the disease and cytologic characteristics of the CSF are noted. Of particular interest were some cases presenting atypical cytologic, as well as clinical, pictures of tuberculous meningitis. These patients had pleocytosis lasting as long as two years. In the first ten days, neutrophils predominated (60% to 80%); then mononuclear cells, such as lymphocytes, lymphoid cells, monocytoid cells and macrophages, became predominant. From the third week of the disease, plasmocytes (20%) were found in 30% of these cases. The presence of reticulomonocytes and reticulohistiocytic cells that could hardly be classified was also noted. By detailed analysis of the cytologic changes in the CSF, the suggestion of a diagnosis of tuberculous meningitis can be made before Koch's bacilli are found, even when the clinical picture and course of the disease are atypical.
本文对10年间84例结核性脑膜炎病例进行了回顾性研究。研究期间对患者进行了腰椎穿刺，并在病程中每周跟踪脑脊液（CSF）细胞学变化动态。记录了典型的临床表现、疾病进程及脑脊液的细胞学特征。特别值得关注的是一些结核性脑膜炎呈现非典型细胞学及临床症状的病例。这些患者的细胞增多症持续长达两年。在最初的十天里，中性粒细胞占主导（60%至80%）；随后单核细胞，如淋巴细胞、类淋巴细胞、单核样细胞和巨噬细胞占主导。从疾病的第三周起，30%的此类病例中发现了浆细胞（20%）。还注意到存在难以分类的网状单核细胞和网状组织细胞。通过对脑脊液细胞学变化的详细分析，即使临床表现和病程不典型，在发现结核杆菌之前也可作出结核性脑膜炎的诊断提示。
