Central Nervous System (CNS) Toxoplasmosis
This image represents a cerebrospinal fluid (CSF) cytospin preparation from a patient who recently received a bone marrow transplant for recurrent central nervous system (CNS) Burkitt's lymphoma. The patient was admitted to the hospital two weeks after transplant due to rapidly altering mental status.
When the CSF cell count demonstrated a high white blood count (WBC) count, the first concern was a possible CNS relapse of the Burkitt's lymphoma. However, the cytospin showed many neutrophils in spite of the patients peripheral blood neutropenia. No malignant cells were identified.
On closer examination of the neutrophil clusters, ovoid inclusions were noted (see arrow) as well as free banana shaped organisms (see circled area).
The ovoid inclusions in the neutrophils and the free forms have lavender cytoplasm with a centrally placed cluster of reddish granules.