Cerebrospinal fluid infiltration by chronic myeloid leukaemia: Evaluation of cytomorphological features

Abstract

Background and Aim To describe the cytomorphological findings of all cerebrospinal fluid (CSF) cytology samples showing infiltration by chronic myeloid leukaemia (CML) and their correlation with haematological findings. Materials and Methods A retrospective analysis of all CSF samples reported as showing infiltration by CML on cytology from January 2014 to December 2021 was performed. Results A total of 10 cases with positive CSF cytology were evaluated. The mean age of the patients was 34.1 years (range 17‐70 years). There were more males than females. All cases were pre‐diagnosed cases of CML on haematological investigations. On cytology, the smears showed atypical/immature blast‐like cells, with a high nucleo‐cytoplasmic ratio, opened‐up chromatin, 1‐2 conspicuous nucleoli and a scant to moderate amount of agranular to fine granular cytoplasm along with occasional granulocytic precursors. The shortest time interval for CSF positivity in a known case of CML was 5 months, and the longest interval was 11 years. Conclusion It is extremely uncommon to encounter CML infiltration in CSF. Timely analysis of CSF cytology samples can allow quick diagnosis and alter the patient management protocol.