The in vivo development of plasma cells: a morphologic study of human cerebrospinal fluid

Plasma cells in cerebrospinal fluid and multiple sclerosis: diagnostic yield and clinicobiological correlations

Cerebrospinal fluid (CSF) cytocentrifugation was performed for plasma cells' demonstration in parallel with white cell count (WCC) and quantitative protein assays. Over a 5-year period, 154 consecutive multiple sclerosis (MS) patients were studied and compared to 28 other inflammatory neurological disease, 85 non-inflammatory neurological disease and 29 non-neurological disease cases. CSF cytology was easy to perform, gave definitive results within 2 h and was abnormal in 80 MS patients, 26 of whom had a normal WCC. Its sensitivity in MS was 0.57, i.e. higher than for WCC (0.45) but lower than for IgG index (0.70) and IgG synthesis rate (0.71). Its specificity was 0.86, not significantly different from specificity of WCC, IgG index and IgG synthesis rate. Plasma cells demonstration in MS CSF was neither a disease activity nor a prognosis marker. It was significantly correlated with pleiocytosis and intrathecal IgG synthesis. If these morphologically defined plasma cells are actual B cells, they could represent circulating individuals of the lymphocyte clones active in MS plaques and have a pathogenetic significance.

Infiltración meningea por leucemia a celulas plasmáticas y por linfoma no Hodgkin: estudio citomorfologico en el liquido cefalo-raquideo

Son presentadas las características citomorfológicas anormales encontradas en el LCR de dos pacientes, uno de ellos sufriendo de leucemia aguda a células plasmáticas y otro de linfoma mixto no Hodgkin. Se enfatiza la importancia del estudio del LCR en estas patologias.

CSF cells in tuberculous meningitis. Humoral and cellular immune response

In 10 patients with tuberculous meningitis both T and B lymphocyte activation was observed in the CSF from clinical onset of disease. During the course of the illness, the humoral response remained most marked, disappearing by 2 months, while the cellular immune response continued for about another 3 months. This contrasts with acute viral meningitis, in which both responses cease within 1-2 weeks of disease.

Cerebrospinal fluid data. 2. Interpretation in intracranial malignancy and multiple sclerosis

In malignancies involving the CNS, notably leukemia, malignant cells may be readily demonstrated in the CSF, directly confirming the diagnosis. Advances in cell isolation techniques have significantly increased the diagnostic yield of CSF cytology. A variety of CSF protein studies and both WBC and differential counts are central to the diagnosis of multiple sclerosis. Protein studies include total protein levels, gamma globulin levels, and electrophoretic techniques designed to demonstrate the fine structure of gamma globulin, ie, its separation into two to ten (or more) oligoclonal bands. Although by no means specific for multiple sclerosis, such bands are strongly supportive of the diagnosis in the correct clinical setting.

An ultrastructural study of the cerebrospinal fluid in visna

An electron microscopic examination was done on 8 samples of cerebrospinal fluid (CSF) from Icelandic sheep infected by the intracerebral route with visna virus. The specimens were collected 1 month, 2 months, and 4 years after infection. A differentail cell count done on low-power electron micrographs showed that the cellular exudate was composed of mononuclear cells mainly macrophages and lymphocytes with a few plasma cells. Macrophages were with one exception more numerous than lymphocytes and an increased proportion of macrophages showed evidence of phagocytosis with time after infection. Reactive lymphocytes were in general more numerous than small lymphocytes. Various stages in the maturation of plasma cells were observed. The cellular composition in the CSF is compatible with the view that visna is an immunopathological process. Myelin figures and fragments of myelinated axons were observed in two specimens indicating an active myelin-breakdown. The possibility that escape of myelin into the CSF may lead to sensitization to myelin antigens and perpetuation of this chronic neurologic affection is discussed. Visna virions could not be demonstrated.

The cerebrospinal fluid in visna, a slow viral disease of sheep

The temporal development of the CSF abnormalities was examined in visna, a chronic neurological disease caused by a persistent viral infection of sheep. Two types of changes were observed. During the first 30 to 40 days there was an intense mononuclear pleocytosis associated with high protein and proportionately elevated IgG. Later, there was a persistent slight pleocytosis associated with mildly elevated protein which had an increased proportion of IgG and antivisna antibody. These later cellular and protein changes are similar to those found in a number of chronic neurological diseases of man.

Multiple sclerosis: diagnostic usefulness of cerebrospinal fluid

Early, atypical, or progressive cases of multiple sclerosis (MS) may be hard to diagnose. Until recently, assays of the most common abnormalities in cerebrospinal fluid were not available in clinical diagnostic laboratories, but now they can be done with relative ease and adequate standardization. With the newer techniques the CSF is abnormal in more than 90% of clinically definite cases of MS, and determination of such changes can be a major aid in diagnosis. The most common CSF abnormalities are discussed: elevation of immunoglobulin G(IgG), expressed as percentage of total protein; elevation of the IgG/albumin index; and presence of oligoclonal IgG bands. Not only does assessment of these CSF proteins provide an improved aid to diagnosis, but their study may furnish important clues to the cause and pathogenesis of MS as well.