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What Does This CSF Report Indicate?
Question: Hello Sir, Is this attach report suggestive of Brain TB? I know you will have lots of questions about other health parameters, however, at this point of time, I could only get the attached LP report from the hospital. Doc says it is TPM. Brain Contrast MRI indicated swelling in brain which has led docs to do LP.
She has been diagnosed with Lung Cancer as well. Staging report is yet to be finalized. PET scan needs to be done yet.
Is it possible that one part of a body has Cancer and other TB? Abnormal masses has been observed in Abdomen and ovaries as well.
Surprisingly, in 2009, my mother was detected with sarcoidosis in Lungs and was on Steroids (Wyslone 60 MG) for three years and then it was ignored.
Can a sarcoidosis be converted to Cancer in 5 years despite of taking Wyslone?
She is 60 years old. She has not eaten any thing for last 45 days, not even on liquid diet. She keeps on vomating randomly. Within last week, she has lost her vision of one eye by 75%, lost her speech by 80%, we can hardly understand her now and her tounge is bit twisted towards right. He one eye has become small as compared to other one.
Please suggest.
She has been diagnosed with Lung Cancer as well. Staging report is yet to be finalized. PET scan needs to be done yet.
Is it possible that one part of a body has Cancer and other TB? Abnormal masses has been observed in Abdomen and ovaries as well.
Surprisingly, in 2009, my mother was detected with sarcoidosis in Lungs and was on Steroids (Wyslone 60 MG) for three years and then it was ignored.
Can a sarcoidosis be converted to Cancer in 5 years despite of taking Wyslone?
She is 60 years old. She has not eaten any thing for last 45 days, not even on liquid diet. She keeps on vomating randomly. Within last week, she has lost her vision of one eye by 75%, lost her speech by 80%, we can hardly understand her now and her tounge is bit twisted towards right. He one eye has become small as compared to other one.
Please suggest.
Brief Answer:
It is likely infectious meningitis,possibly TBM.
Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I have been through your csf report.
Your csf report shows 55 cells with 95% lymphocytes.Csf protein is 336,which is high and sugar is 25 which is very low.
Pleocytosis with lymphocytes predominance,high protein and low sugar goes in favour of Tuberculous meningitis.So,TBM is likely.
However,fungal and malignant meningitis should be ruled out.So,CSF should be analysed for fungal antigen,fungal stain and malignant cells.
With background history of cancer,it should not be presumed that it is TBM only unless we rule out malignant cells in csf.Though,cancer is a state of immunosuppression and increases the risk for TBM.
Sarcoidosis is not known to convert into cancer.Vision and speech other focal abnormalities may occur in any one-TBM,fungal or malignant meningitis.
Waiting for your follow-up question.If you don't have any,please close the thread-rate it and write a review.Your rating will be of help to me.
Dr.Ajay Panwar,
MD,DM(Neurology)
It is likely infectious meningitis,possibly TBM.
Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I have been through your csf report.
Your csf report shows 55 cells with 95% lymphocytes.Csf protein is 336,which is high and sugar is 25 which is very low.
Pleocytosis with lymphocytes predominance,high protein and low sugar goes in favour of Tuberculous meningitis.So,TBM is likely.
However,fungal and malignant meningitis should be ruled out.So,CSF should be analysed for fungal antigen,fungal stain and malignant cells.
With background history of cancer,it should not be presumed that it is TBM only unless we rule out malignant cells in csf.Though,cancer is a state of immunosuppression and increases the risk for TBM.
Sarcoidosis is not known to convert into cancer.Vision and speech other focal abnormalities may occur in any one-TBM,fungal or malignant meningitis.
Waiting for your follow-up question.If you don't have any,please close the thread-rate it and write a review.Your rating will be of help to me.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Hello Sir,
Thank you for your quick reply. This report is not mine, but of my mother who is 60 yrs old.
If it is TBM, will she be able to recover? Whats the time frame?
She has only eaten 10% of 40 days diet including liquid intake. Is this also related to Brain TBM? Will she start eating again?
Please help me by elaborating CSF should be ruled out for three more things. Will LP culture rule that out? The LP culture report is yet to come.
Or do we need to get more tests done for that?
I know that Lungs is not your area, however, just wanted to share the biopsy report, which has been released just now. Please review if it has any relevance.
We are not sure what is the cancer stage as of now, if it will need kemo or radio?
Regards,
Thank you for your quick reply. This report is not mine, but of my mother who is 60 yrs old.
If it is TBM, will she be able to recover? Whats the time frame?
She has only eaten 10% of 40 days diet including liquid intake. Is this also related to Brain TBM? Will she start eating again?
Please help me by elaborating CSF should be ruled out for three more things. Will LP culture rule that out? The LP culture report is yet to come.
Or do we need to get more tests done for that?
I know that Lungs is not your area, however, just wanted to share the biopsy report, which has been released just now. Please review if it has any relevance.
We are not sure what is the cancer stage as of now, if it will need kemo or radio?
Regards,
Brief Answer:
Exact period of recovery can't be defined.
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up and providing further inputs.
Please find precise answers to your queries as follows:
TBM is a serious illness.Patients may or may not recover.It actually depends on the clinical condition and radiological status of disease like degree of hydrocephalus,arachnoiditis,infarcts,edema and granulomas at critical locations.
Every patient responds differently to treatment.However,better consciousness level at presentation predicts better recovery.Is she conscious and responding to instructions at present?If yes,it increases the chances of recovery.However,the natural history of the disease is such that sometimes worsening may start occuring after patient has observed improvement.Besides all, More than 50 percent patients usually show improvement,if taking treatment properly as advised.Antituberculous drugs along with steroids are the mainstay of treatment.
She is probably eating less due to recurrent vomiting as well as due to the poor general condition.As the disease condition improves along with vomiting,she will likely improve on feeding.
LP culture can rule out tuberculosis and bacterial meningitis.For ruling out fungus infection,CSF needs to be analysed for 'KOH' mount for fungus and cryptococcal LA antigen.For malignancy or cancer associated meningitis,CSF should be checked for 'malignant cells'.LP culture will not rule out all three.
Lung biopsy says adenocarcinoma as the lung cancer.It may be contributing to the meningitis and CSF should be ruled out for malignant cells.
Regarding staging and deciding the therapy,whether radiotherapy or chemotherapy?-a Medical oncologist should be consulted.
Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.Your rating will be of help to me.
Dr.Ajay Panwar,
MD,DM(Neurology)
Exact period of recovery can't be defined.
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up and providing further inputs.
Please find precise answers to your queries as follows:
TBM is a serious illness.Patients may or may not recover.It actually depends on the clinical condition and radiological status of disease like degree of hydrocephalus,arachnoiditis,infarcts,edema and granulomas at critical locations.
Every patient responds differently to treatment.However,better consciousness level at presentation predicts better recovery.Is she conscious and responding to instructions at present?If yes,it increases the chances of recovery.However,the natural history of the disease is such that sometimes worsening may start occuring after patient has observed improvement.Besides all, More than 50 percent patients usually show improvement,if taking treatment properly as advised.Antituberculous drugs along with steroids are the mainstay of treatment.
She is probably eating less due to recurrent vomiting as well as due to the poor general condition.As the disease condition improves along with vomiting,she will likely improve on feeding.
LP culture can rule out tuberculosis and bacterial meningitis.For ruling out fungus infection,CSF needs to be analysed for 'KOH' mount for fungus and cryptococcal LA antigen.For malignancy or cancer associated meningitis,CSF should be checked for 'malignant cells'.LP culture will not rule out all three.
Lung biopsy says adenocarcinoma as the lung cancer.It may be contributing to the meningitis and CSF should be ruled out for malignant cells.
Regarding staging and deciding the therapy,whether radiotherapy or chemotherapy?-a Medical oncologist should be consulted.
Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.Your rating will be of help to me.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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