Atlas de citologia do líquor: um guia prático para apoio médico-laboratorial em neurodiagnósticos

Abstract

Cytological analysis of cerebrospinal fluid (CSF) is an essential tool in the diagnosis of several pathologies of the central nervous system, such as meningitis, neoplasia, subarachnoid hemorrhage and inflammatory diseases. Accurate identification of cells in CSF depends on the correlation between automated and manual counting methods, as well as techniques for visualization and morphological characterization. The main objective of this study was to develop an atlas of CSF cytology, based on images captured by digital scanner, as a resource to support medical-laboratory diagnosis in neurodiagnostics. A total of 104 CSF samples from patients admitted to the Pedro Ernesto University Hospital (HUPE/UERJ) were used, and submitted to cell counting by cytometry and Fuchs-Rosenthal chamber. The slides were prepared in a Cytocentrifuge (cytospin), stained by the Wright method and digitized by the CellaVision® DM9600 system. The resulting images were organized and described in an illustrated atlas, highlighting cells such as lymphocytes, neutrophils, eosinophils, blasts, macrophages, neoplastic cells, bacterial and fungal structures, among others. As an additional product, a reformulation of the traditional cytology report was proposed, suggesting the inclusion of cell groups of clinical relevance. The atlas aims to contribute to the training of health professionals and the standardization of diagnostics in specialized laboratories.