Electrophoretic analysis of cerebrospinal fluid proteins in patients with central nervous system mass lesions

Abstract

✓ The protein constituents of the cerebrospinal fluid (CSF) from 234 patients with central nervous system mass lesions and nine patients with pseudotumor syndrome were analyzed by cellulose acetate electrophoresis. The alpha 2 and gamma globulin fractions were most frequently elevated, and more so with metastatic and malignant glial tumors than with benign tumors. Elevation of either fraction frequently occurred independent of the total protein content of the CSF and appears to indicate a primary parenchymal involvement of the brain. Gamma globulin elevations in patients with benign glial tumors were often associated with intracerebral cyst formation. Pituitary adenomas were not associated with elevation of the gamma globulin fraction whereas this was a common finding with other parasellar lesions. All CSF specimens associated with masses of infectious origin had markedly elevated gamma globulin levels irrespective of normal total protein levels. Two metastatic tumors from the gastrointestinal tract, a solitary plasmacytoma, and a case of increased intracranial pressure secondary to nalidixic acid therapy showed dramatic and specific increases in certain CSF protein fractions. The origin of the various protein fractions is discussed as well as the overall clinical applicability of CSF protein electrophoresis in patients with intracranial mass lesions.