DQ stain: Low power
Numerous plasma cells with occasional binucleated forms
Plasma cells are not normally present in CSF
Presence of plasma cells indicates chronic inflammation or neoplasia
DQ stain: High power
Numerous plasma cells including immature cells and occasional binucleated forms
Immature plasma cells and binucleation are suggestive of myeloma
Pap stain: High power
Numerous immature plasma cells suggestive of myeloma
Pap stain: High power
Numerous immature plasma cells suggestive of myeloma
Features
• Myeloma involving CSF is rare
• Plasma cells normally not seen in CSF except infection (viral) or neoplasia
• Immature forms of plasma cells are diagnostic
• Cellularity varies
• Malignant cells with plasmacytoid features
• Cytoplasm moderate
• Nuclei round, eccentrically located
• Binucleation often seen
• Clockwork chromatin