HCDP Manchester

CSF Analysis

PATHWAY OPTIONS

There are a number of choices, please ensure you select the correct pathway for your sample. Please give as much clinical detail as possible for all samples

Pathway 1A: Morphology (with flow if abnormal)

Order when risk of CNS disease is low. A cell count will be performed and if this shows a high white cell count (>5 cells/µl) then the remaining sample will be passed to the flow cytometry lab (providing sample volume is sufficient). If a relapse is suspected it is better to choose Pathway 1B or 1C.
The tests that will be performed:

  • Morphology

Pathway 1B: CSF morphology and flow cytometry blast panel

Select if CNS involvement by acute leukaemia is known to be present or is strongly suspected.
The tests that will be performed:

  • CSF: Morphology
  • CSF: Flow cytometry (blast markers)

Pathway 1C: CSF morphology and flow cytometry lymph panel

Selected if CNS involvement by LPD or lymphoma is known to be present or is strongly suspected.
The tests that will be performed:

  • CSF: Morphology
  • CSF: Flow cytometry (lymphoid markers)

Pathway 1D: Flow cytometry only assess blasts

Use if CNS involvement by acute leukaemia is suspected based on a cytospin already performed at the referring hospital. This can be sent if n a preservation medium such as ‘Cytofix’ media if for flow cytometry only.
The tests that will be performed:

  • CSF: Flow cytometry blast markers (sample sent in Cytofix)

Pathway 1E: CSF flow cytometry only assess lymphs

Use if CNS involvement by lymphoma or LPD is suspected based on a cytospin already performed at the referring hospital. This can be sent if n a preservation medium such as ‘Cytofix’ media if for flow cytometry only.
The tests that will be performed:

  • CSF: Flow cytometry lymphoid markers (sample sent in Cytofix)

Pathway 1F: CSF special test

Use if a special test (e.g. molecular test) is required. This MUST be discussed first
The following tests will be performed:

  • CSF: Morphology
  • CSF: molecular test (requires discussion first)