The Clinical Significance of Cerebrospinal Fluid Cytology Presenting Mixed Cell Reaction

Objective To explore the diagnostic value of tuberculous meningitis and the clinical signficance of differential diagnosis with other diseases,as cerebrospinal fluid cytology presenting mixed cell reaction.Methods Five hundred and forty eight cases of cerebrospinal fluid cytology were examined using Shu's cells differential count method to count the cells in cerebrospinal fluid.Seventy-three cases presenting mixed-cell response in these examinations were analyzed.Results In the 73 cases the percentage of the 55 cases presenting mixed cell reaction in the all tuberculous meningitis cases was 87.3%(55/63 cases),virus meningitis was 3.5%(7/202 cases),cryptococcal meningitis was 100.0%(3/3 cases),purulent meningitis was 4.8%(2/42 cases),meningeal carcinomatosis was 8.7%(2/23 cases),immuno-inflammation was 2.7%(2/74 cases),other diseases was 1.5%(2/131 cases).Virusmeningitis cases present mixed cell reaction usually in 3 days,at most within 7 days.It is a relatively long duration for the cryptococcal meningitis cases presenting mixed cell reaction.The purulent meningitis cases early present neutrophil reaction.Only aftter short term therapy,did the cerebrospinal fluid cytology present mixed cell reaction.The total number of cells and percentage of neutrophil are small in non-infective diseases.It is possible to find malignant cells in meningeal carcinomatosis cases.Conclusion Cerebrospinal fluid cytology presents mixed cell reaction commonly in tubercular meningitis cases.Still,it is necessary to combined with case history and course of disease in differential diagnosis,and dynamic observing the change of the cytology is more meaning in differential diagnosis.