Naslov
Utility of flow cytometry in FNA cytologic diagnosis and subclasification of primary and recurrent lymphoma

Autori
Šiftar, Zoran ; Kardum Paro, Mirjana Mariana ; Sokolić, Ivica ; Kardum-Skelin, Ika ; Jelić Puškarić, Biljana ; Flegar-Meštrić, Zlata.

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Cytopathology, 23 (Suppl 1) / Herbert, Amanda - Oxford : Wiley-Blackwell, 2012, 55-55

Skup
37th European Congress of Cytology

Mjesto i datum
Cavtat, Hrvatska, 30.09.2012. - 03.10.2012

Vrsta sudjelovanja
Pozvano predavanje

Vrsta recenzije
Nije recenziran

Ključne riječi
FNA; subclassification; lymphoma

Sažetak
Aim: Fine needle aspiration (FNA) cytology is a valuable method for diagnosing and subclassifying Non-Hodgkin lymphomas (NHLs), although immunophenotyping by flow cytometry (FCI) is often an essential ancillary test. Establishing the utility of FCI for screening and diagnosis of primary and recurrent NHLs, as well its potency in evaluation of treatment effectiveness, a retrospective review of lymph node FNAs submitted to Institute of Clinical Chemistry was done. Methods: We compared prospectively FCI vs. cytology analysis of 194 FNA samples collected during 2011 for the diagnostic screening and further World Health Organization (WHO) subclassification of lymphomas. Multicolor FCI, 4 or 5 antibodies per tube, has been made on mononuclear cells isolated through Nycoprep 1.077 density gradient. All measurements were made on the FC500 flow cytometer, Beckman Coulter. In Institute of Clinical Chemistry, FCI is accredited method according to laboratory accreditation standard ISO 15189. Cytomorphological analysis was done on MGG stained smears and complemented with routine cytochemistry/immunocitochemistry tests in Department of Clinical Cytology and Cytogenetics. Both laboratories have participated in UK NEQAS for Leukocyte Immunophenotyping external quality assessment (EQA)program assuring integrity and quality of the entire laboratory process. Results: FCI analysis could be performed for only 150 samples (85.3%). Forty four samples were rejected from further analysis due to insufficient cellularity, diagnosis of metastatic carcinoma, or granulomatous lesion. Cytological analysis revealed 52 benign proliferations (BPs). The rest were lymphoma’s cells classified according to WHO classification as Hodgkin lymphoma, T- or B-origin neoplasms in eight, five and 85 cases, respectively. T-malignancy comprised Peripheral T-cell lymphoma, unspecified, Lennert’s lymphoma, and T-precursor acute leukaemia, in 3, 1, and 1 case, respectively. B-neoplasms included 24 chronic lymphocytic leukaemia/small lymphocytic lymphoma (B-CLL/SLL), and 61 B-NHL: BNHL unspecified 5, follicular lymphoma (FL) 20, mantle-cell lymphoma (MCL) nine, immunocytoma (IC) two, mucosa associated lymphoid tissues lymphoma (MALT), six, marginal zone lymphoma (MZL) 1, and diffuse large B cells lymphoma (DLBCL) 18, respectively. Normal phenotype was confirmed for all BPs (100% concordance). Pathological phenotype indicative for malignant proliferation was found in 85 of 90 NHLs, particularly in defining of B-cell neoplasms (97.6% concordance). A relatively high degree of agreement (65.9%) was found between FCI and cytology in subtyping B-NHL. In this regard, MCL, FL, B-NHL unspecified, and BCLL/SLL showed the highest degree of agreement (88.9%, 85%, 80%, and 79.2% concordant rates, respectively). Detection of minimal residual disease by FCI analysis was included for four patients. It was successful in two cases, but remaining two had insufficient cellularity in several attempts during treatment period. False negative results by FCI, observed as normal phenotype, was seen in one case of B-CLL and one in B-NHL, as well in three cases of T-NHL, respectively. The antibody combination used did not allow a positive diagnosis of Hodgkin lymphoma as distinct from a BP in all cases. Conclusions: FCI enhances the diagnostic ability of FNA cytology, playing an important role in a rapid and accurate differential diagnosis between BP and B-NHL, although it is less successful in diagnosis of T-NHL.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti

POVEZANOST RADA