J Pathol Transl Med.  2018 Jan;52(1):61-63. 10.4132/jptm.2017.06.13.

Liquid-Based Cytology of the Cerebrospinal Fluid in a Case of Cryptococcal Meningitis

Affiliations
  • 1Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 2Department of Pathology, Yonsei University College of Medicine, Seoul, Korea. paxco@yuhs.ac

Abstract

Cryptococcus neoformans is the most common microorganism found in cerebrospinal fluid (CSF) cytology and causes life-threatening infections in immunocompromised hosts. Although its cytomorphologic features in conventional smear cytology have been well described, those in liquid-based cytology have rarely been. A 73-year-old woman with diffuse large B-cell lymphoma presented with mental confusion and a spiking fever. To rule out infectious conditions, CSF examination was performed. A cytology slide that was prepared using the ThinPrep method showed numerous spherical yeast-form organisms with diameters of 4-11 μm and thick capsules. Occasional asymmetrical, narrow-based budding but no true hyphae or pseudohyphae were observed. Gomori methenamine silver staining was positive. Cryptococcosis was confirmed in blood and CSF through the cryptococcal antigen test and culture. Liquid-based cytology allows for a clean background and additional slides for ancillary testing, facilitating the detection of microorganisms in CSF specimens, particularly when the number of organisms is small.

Keyword

Cryptococcus neoformans; Cerebrospinal fluid; Liquid-based cytology

MeSH Terms

Aged
Capsules
Cerebrospinal Fluid*
Cryptococcosis
Cryptococcus neoformans
Female
Fever
Humans
Hyphae
Immunocompromised Host
Lymphoma, B-Cell
Meningitis, Cryptococcal*
Methenamine
Methods
Capsules
Methenamine
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