Page 245 - Clinical Hematology Atlas

CHAPTER 24 BODY FLUIDS 229

CELLS SOMETIMES FOUND IN CEREBROSPINAL FLUID AFTER CENTRAL NERVOUS
SYSTEM HEMORRHAGE
The following sequence of events is a typical reaction to intracranial hemorrhage or repeated
lumbar punctures:
1. Neutrophils and macrophages—appear within 2 to 4 hours
2. Erythrophages—identifiable from 1 to 7 days
3. Hemosiderin and siderophages—observable from 2 days to 2 months
4. Hematoidin crystals—recognizable in 2 to 4 weeks

FIGURE 24–8 Erythrophage (CSF 31000). FIGURE 24–9 Hemosiderin (CSF 31000).

Macrophage with engulfed RBCs. RBCs are Blue to black granules that contain iron, resulting
digested by enzymatic activity within the macro- from the degradation of hemoglobin, may be present
phage. The digestion process causes the RBCs to in CSF for up to 2 months after intracranial
lose color and to appear as vacuoles within the hemorrhage. The cellular inclusions can be posi-
cytoplasm of some macrophages. tively identified with an iron stain.