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Body Fluids

Cerebral Spinal Fluids (CSF)
CSF Sample Collection
Lumbar Tap.jpg

CSF Order of Draw

3-Tube Draw

  1. Chemistry

  2. Microbiology

  3. Hematology

4-Tube Draw

  1. Hematology

  2. Chemistry

  3. Microbiology

  4. Hematology

CSF normal_xanthochromia_traumatic tap.p
CSF normal_xanthochromia_traumatic tap.p

Traumatic Tap

CSF sample collected is pinkish red, indicating the presence of blood.

Will show progressively decreasing RBC in serial samples

Bloody CSF samples can also be resulted from: 

  • Subarachnoid hemorrhage

  • Intracerebral hemorrhage

  • Infarct

However, RBCs would be consistent from one tube to the next.

Microscopic Observation of CSF



  • Refers to a pink, orange or yellow color of the CSF supernatant after the CSF has been centrifuged 

Clinical Indication:

  • Hyperbilirubinemia

  • Increased Protein

Subarachnoid Hemorrhage vs Traumatic Tap

After centrifuging a pigmented CSF sample, if the supernatant is...

  • Clear- traumatic tap

  • Xanthochromic- subarachnoid hemorrhage



  • Increased WBC (pleocytosis)

Cell Count in CSF

Increased WBCs: 

  • inflammation of the CNS, particularly the meninges

Increased Nutrophils (Neutrophilia):

  • bacterial infections

Increased Mononuclear Cell:

  • Viral Infection

  • Cerebral abscess

  • Acute Leukemia

  • Lymphoma

  • Intracranial vein thrombosis

  • Cerebral tumor

  • Multiple Sclerosis

Ependymal Cells

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  • Single or in clumps

  • Nuclei are round to oval with a definitive smooth nuclear membrane

  • No nucleoli present

  • Chromatin is distributed evenly & is finely granular or hyperchomatic

  • Cytoplasm can be basophilic or pink

  • Microvilli may be present

Ependymal Cells.jpg

Clinical Indication:

  • Traumatic Tap 

  • CNS Infection

  • Subarachnoid hemorrhage

  • Hydrocephaly in children



Contains phagocytized WBC


Contains phagocytized RBC or RBC fragments


Contains phagocytized particles of hemosiderin


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