Two cases with discrepancy in the quantitative cytological assessment of cerebrospinal fluid in neonatal samples using light microscopy in comparison with Sysmex XN-1000

Abstract

Graphical abstract Highlights • Quantitative cytological examination using Sysmex XN-1000 is faster in comparison with the manual technique • The low required sample volume for analysis using Sysmex XN-1000 can be beneficial, especially in neonatal patients • The misdiagnosis because of the incorrect differentiation of white blood cells can have negative impact in cases when the sample volume is insufficient and the cytospin slide is not investigated simultaneously We present two cases from the neonatal department with cerebrospinal fluid examination. We revealed a striking discrepancy in polymorphonuclear (PMN) and mononuclear (MN) cell counts using conventional light microscopy in comparison with automated analyzer Sysmex XN-1000 (PMNs - 13 vs. 173x106/L, MNs - 200 vs. 67x106/L in case 1 and PMNs - 13 vs. 372x106/L, MNs - 411 vs. 179x106/L in case 2). We revealed the dominant presence of hemosiderophages in both cases in cytospin slide. Even though Sysmex XN-1000 offers fast examination with a low sample volume, there is possibility of misdiagnosis, with negative impact on the patient.