Ependymal-choroidal cells in cerebrospinal fluid

Increased incidence in hydrocephalic infants

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✓ Samples of cerebrospinal fluid removed from 66 patients with various non-neoplastic disorders during pneumoencephalography or ventriculography were examined cytologically using the method of Millipore filtration. In addition to leukocytes and other types of cells, clumps of ependymal or choroidal cells were frequently noted; they were found most often and in greatest numbers in hydrocephalic infants. The authors hypothesize that these cells are constantly being shed and replaced, especially during infancy, and that their exfoliation is increased if the ventricles are stretched by hydrocephalus. It is important that one recognizes the nature of these clumps of ependymal or choroidal cells to avoid misidentifying them as leukocytes or tumor cells.

Article Information

Address reprint requests to: Robert H. Wilkins, M.D., Department of Neurosurgery, Scott and White Clinic, Temple, Texas 76501.

© AANS, except where prohibited by US copyright law.

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Figures

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    Photomicrographs of samples of spinal fluid removed by lumbar puncture. Left: Sample from a 14-year-old boy, 8 days after a craniotomy. The clump of histiocytes (below) is readily identified by the granular phagocytized material and vacuoles within their cytoplasm. A single lymphocyte is seen above. Right: Sample from a 35-year-old woman. Squamous epithelial cells are present, with abundant cytoplasm and well-defined cell outlines. Millipore filter, × 1750.

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    Photomicrographs of 8 ml samples of ventricular fluid removed during ventriculogram. Upper Left: Sample from an 8-month-old boy with obstructive hydrocephalus, showing a small clump of ependymal or choroidal cells. Upper Right: Sample from a 3-month-old boy with communicating hydrocephalus. Part of a large clump of ependymal or choroidal cells is present. Lower Right: Sample from a 7-month-old boy with communicating hydrocephalus. A clump of ependymal or choroidal cells is seen. Millipore filter, × 1050.

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