Immunocytochemical identification of meningeal leukemia and lymphoma:
poly-L-lysine-coated slides permit multimarker analysis even with minute
cerebrospinal fluid cell specimens
BR Kranz, E Thiel and S Thierfelder
Institut fur Immunologie, GSF, Munchen, FRG.
Use of immunocytology for accurate identification of malignant cells in
cerebrospinal fluid (CSF) has so far been hampered by high cell
requirements of the immunologic methods hitherto used. In an attempt to
minimize cell loss in cytopreparation, electrostatic binding of cells to
poly-L-lysine (PLL)-coated multispot slides, followed by
immunocytochemistry, was investigated. Using optimized conditions of cell
attachment and fixation and performing all washing procedures on the slide
made multimarker analysis possible even in paucicellular specimens, while
preserving excellent cell morphology and yielding high sensitivity in the
detection of antigens. In a study of 26 CSF specimens with inconclusive
cytomorphology, comprising 335 single marker determinations, we were able
to discriminate reliably between resting or activated benign cells and a
wide range of types of malignant lymphoid cell. A definitive diagnosis was
reached in all cases by one tap only. Malignant meningitis was ruled out in
ten specimens and proved in 16, including five in which the type of
malignancy could only be determined by immunophenotyping. We conclude that
immunocytochemistry on PLL-coated slides constitutes the method of choice
for immunologic cell differentiation in CSF, which allows equivocal
morphologic findings to be clarified.
Volume 73,
Issue 7,
pp. 1942-1950,
05/15/1989
Copyright © 1989 by The American Society of Hematology
