Station 5
Dx: Neutrophilic pleocytosis. There is a predominance of moderately well-preserved neutrophils. There are also a couple of large mononuclear cells and a lymphocyte. The three eosinophilic blobs are likely nuclear remnants of damaged cells, and should be discarded when performing a differential count. Clearly, the predominant cell type is the neutrophil, hence this is a neutrophilic pleocytosis. Remember, normal CSF contains VERY FEW cells, and on a view like this you might expect to see one, or maybe two, cells, or perhaps none at all.
Station 3
Dx: Malignant spindle-cell neoplasm (sarcoma). Note that not all cells appear spindle-shaped, however some have a classic spindle-cell appearance (bipolar cytoplasm). We can be pretty confident that all cells represent the same population (staining characteristics are similar), therefore we can classify this as a spindle cell cell type. Plenty of criteria of malignancy are present, including anisocytosis, anisokaryosis, large nuclear:cytoplasmic ratio, prominent, often multiple nucleoli, an open (or euchromatic) chromatin pattern. All these features indicate that the cells are very active i.e. malignant.
Station 1
Dx: Lymphadenitis (there are much greater than 5% neutrophils in a background of red blood cells and lymphocytes / lymphoblasts, no evidence of neoplasia is present) A reactive lymph node (reactive hyperplasia) would be expected to contain fewer than 5% neutrophils, and a predominance of plasma cells and lymphpocytes at various stages of development. A picture of reactive hyperplasia is shown to the right. There are some neutrophils present, but they dont predominate. Many plasma cells (look for the perinuclear clearing the Golgi zone) are present.