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Jin J, Mao X, Zhang D. A differential diagnosis method for systemic CAEBV and the prospect of EBV-related immune cell markers via flow cytometry. Ann Med 2024; 56:2329136. [PMID: 38502913 PMCID: PMC10953786 DOI: 10.1080/07853890.2024.2329136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 02/23/2024] [Indexed: 03/21/2024] Open
Abstract
Chronic active Epstein-Barr virus (CAEBV) infection of the T-cell or Natural killer (NK)-cell type, systemic form (systemic CAEBV or sCAEBV) was defined by the WHO in 2017 as an EBV-related lymphoproliferative disorder and is listed as an EBV-positive T-cell and NK-cell proliferation. The clinical manifestations and prognoses are heterogeneous. This makes systemic CAEBV indistinguishable from other EBV-positive T-cell and NK-cell proliferations. Early diagnosis of systemic CAEBV and early hematopoietic stem cell transplantation can improve patient prognosis. At present, the diagnosis of systemic CAEBV relies mainly on age, clinical manifestations, and cell lineage, incurring missed diagnosis, misdiagnosis, long diagnosis time, and inability to identify high-risk systemic CAEBV early. The diagnostic methods for systemic CAEBV are complicated and lack systematic description. The recent development of diagnostic procedures, including molecular biological and immunological techniques such as flow cytometry, has provided us with the ability to better understand the proliferation of other EBV-positive T cells and NK cells, but there is no definitive review of their value in diagnosing systemic CAEBV. This article summarizes the recent progress in systemic CAEBV differential diagnosis and the prospects of flow cytometry.
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Affiliation(s)
- Jie Jin
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xia Mao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Donghua Zhang
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Horna P, Weybright MJ, Ferrari M, Jungherz D, Peng Y, Akbar Z, Tudor Ilca F, Otteson GE, Seheult JN, Ortmann J, Shi M, Maciocia PM, Herling M, Pule MA, Olteanu H. Dual T-cell constant β chain (TRBC)1 and TRBC2 staining for the identification of T-cell neoplasms by flow cytometry. Blood Cancer J 2024; 14:34. [PMID: 38424120 PMCID: PMC10904869 DOI: 10.1038/s41408-024-01002-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
The diagnosis of leukemic T-cell malignancies is often challenging, due to overlapping features with reactive T-cells and limitations of currently available T-cell clonality assays. Recently developed therapeutic antibodies specific for the mutually exclusive T-cell receptor constant β chain (TRBC)1 and TRBC2 isoforms provide a unique opportunity to assess for TRBC-restriction as a surrogate of clonality in the flow cytometric analysis of T-cell neoplasms. To demonstrate the diagnostic utility of this approach, we studied 164 clinical specimens with (60) or without (104) T-cell neoplasia, in addition to 39 blood samples from healthy donors. Dual TRBC1 and TRBC2 expression was studied within a comprehensive T-cell panel, in a fashion similar to the routine evaluation of kappa and lambda immunoglobulin light chains for the detection of clonal B-cells. Polytypic TRBC expression was demonstrated on total, CD4+ and CD8+ T-cells from all healthy donors; and by intracellular staining on benign T-cell precursors. All neoplastic T-cells were TRBC-restricted, except for 8 cases (13%) lacking TRBC expression. T-cell clones of uncertain significance were identified in 17 samples without T-cell malignancy (13%) and accounted for smaller subsets than neoplastic clones (median: 4.7 vs. 69% of lymphocytes, p < 0.0001). Single staining for TRBC1 produced spurious TRBC1-dim subsets in 24 clinical specimens (15%), all of which resolved with dual TRBC1/2 staining. Assessment of TRBC restriction by flow cytometry provides a rapid diagnostic method to detect clonal T-cells, and to accurately determine the targetable TRBC isoform expressed by T-cell malignancies.
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Affiliation(s)
- Pedro Horna
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA.
| | | | | | - Dennis Jungherz
- Department of Internal Medicine, University of Cologne, Cologne, Germany
| | - YaYi Peng
- Department of Internal Medicine, University of Cologne, Cologne, Germany
| | | | | | | | | | - Janosch Ortmann
- Centre de Recherches Mathematiques, Universite du Quebec a Montreal, Montreal, Canada
| | - Min Shi
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | | | - Marco Herling
- Department of Internal Medicine, University of Cologne, Cologne, Germany
| | - Martin A Pule
- Autolus Ltd, London, UK
- Cancer Institute, University College London, London, UK
| | - Horatiu Olteanu
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
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Castillo F, Morales C, Spralja B, Díaz-Schmidt J, Iruretagoyena M, Ernst D. Integration of T-cell clonality screening using TRBC-1 in lymphoma suspect samples by flow cytometry. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2024; 106:64-73. [PMID: 38010106 DOI: 10.1002/cyto.b.22147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/23/2023] [Accepted: 10/12/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND The diagnosis of T-cell non-Hodgkin lymphomas (NHL) is challenging. The development of a monoclonal antibody specific for T-cell receptor β constant region 1 (TRBC1) provides an alternative to discriminate clonal T cells. The aim of this study was to evaluate the diagnostic potential of an anti-TRBC1 mAb for the identification of T-NHL. METHODS We performed a cross-sectional diagnostic analytic study of samples tested for lymphoma. All samples sent for lymphoma screening were first evaluated using the standard Euroflow LST, to which a second additional custom-designed T-cell clonality assessment tube was added CD45/TRBC1/CD2/CD7/CD4/TCRγδ/CD3. Flow cytometry reports were compared with morphological and molecular tests. RESULTS Fifty-nine patient samples were evaluated. Within the T-cell population, cut-off percentages in the CD4+ cells were from 29.4 to 54.6% and from 23.9 to 52.1% in CD8+ cells. Cut-off ratios in CD4+ T cells were from 0.33 to 1.1, and in CD8+ cells between 0.22 and 1.0. Using predefined normal cut-off values, 18 of 59 (30.5%) samples showed a restricted expression of TRBC1. A final diagnosis of a T-NHL was confirmed clinically and/or by histopathological studies in 15 of the 18 cases (83.3%). There were no cases of T-NHL by morphology/IHC with normal TRBC1 expression. Non-neoplastic patient samples behaved between predefined TRBC1 cut-off values. CONCLUSIONS Expression of TRBC1 provides a robust method for T-cell clonality assessment, with very high sensitivity and good correlation with complementary methods. TRBC1 can be integrated into routine lymphoma screening strategies via flow cytometry.
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Affiliation(s)
- Felipe Castillo
- Laboratorio Clínico, Clínica Alemana de Santiago, Vitacura, Chile
| | | | - Biserka Spralja
- Laboratorio Anatomía Patológica, Clínica Alemana de Santiago, Vitacura, Chile
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Joaquín Díaz-Schmidt
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
- Departamento de Oncología, Clínica Alemana de Santiago, Vitacura, Chile
| | - Mirentxu Iruretagoyena
- Laboratorio Clínico, Clínica Alemana de Santiago, Vitacura, Chile
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Daniel Ernst
- Laboratorio Clínico, Clínica Alemana de Santiago, Vitacura, Chile
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
- Departamento de Oncología, Clínica Alemana de Santiago, Vitacura, Chile
- Instituto de Ciencia e Innovación en Medicina (ICIM), Universidad del Desarrollo, Santiago, Chile
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Chan A, Gao Q, Roshal M. 19-color, 21-Antigen Single Tube for Efficient Evaluation of B- and T-cell Neoplasms. Curr Protoc 2023; 3:e884. [PMID: 37725693 PMCID: PMC10516508 DOI: 10.1002/cpz1.884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Non-Hodgkin lymphoma (NHL) is a heterogeneous disease, encompassing a wide variety of individually distinct neoplastic entities of mature B-, T-, and NK-cells. While they constitute a broad category, they are the most common hematologic malignancies in the world. The distinction between different neoplastic entities requires a multi-modal approach, such as flow cytometric immunophenotyping, which can exclude a neoplastic proliferation and help narrow the differential diagnosis. This article describes a flow cytometric test developed at Memorial Sloan Kettering Cancer Center to assess B-, T-, and NK-cells in a single tube, 21-antibody, 19-color assay. The assay can identify most B- and T-cell NHLs with high specificity and sensitivity and significantly narrow the differential when a specific diagnosis cannot be made. The basic protocol provides a detailed operational procedure for sample processing, staining, and cytometric acquisition. The support protocol provides typical steps and caveats for data analysis in lymphoproliferative disorders and in discriminating a variety of specific disease entities from each other and normal lymphoid populations. © 2023 Wiley Periodicals LLC. Basic Protocol: Processing, staining, and cytometric analysis of samples for B- and T-cell assessment Support Protocol: Analysis and interpretation of the B- and T-cell lymphocyte assay.
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Affiliation(s)
- Alexander Chan
- Hematopathology service, Memorial Sloan Kettering Cancer Center, Department of Pathology and Laboratory Medicine, New York, New York
| | - Qi Gao
- Hematopathology service, Memorial Sloan Kettering Cancer Center, Department of Pathology and Laboratory Medicine, New York, New York
| | - Mikhail Roshal
- Hematopathology service, Memorial Sloan Kettering Cancer Center, Department of Pathology and Laboratory Medicine, New York, New York
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Seheult JN, Otteson GE, Jevremovic D, Horna P, Timm MM, Yuan J, Morice WG, Olteanu H, Shi M. Establishing NK-Cell Receptor Restriction by Flow Cytometry and Detecting Potential NK-Cell Clones of Uncertain Significance. Mod Pathol 2023; 36:100255. [PMID: 37385341 DOI: 10.1016/j.modpat.2023.100255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/01/2023]
Abstract
Natural killer (NK) cells develop a complex inhibitory and/or activating NK-cell receptor system, including killer cell immunoglobulin-like receptors (KIRs or CD158) and CD94/NKG2 dimers, which are variably combined to generate the individual's NK-cell receptor repertoire. Establishing NK-cell receptor restriction by flow cytometric immunophenotyping is an important step in diagnosing NK-cell neoplasms, but reference interval (RI) data for interpreting these studies are lacking. Specimens from 145 donors and 63 patients with NK-cell neoplasms were used to identify discriminatory rules based on 95% and 99% nonparametric RIs for CD158a+, CD158b+, CD158e+, KIR-negative, and NKG2A+ NK-cell populations to establish NK-cell receptor restriction. These 99% upper RI limits (NKG2a >88% or CD158a >53% or CD158b >72% or CD158e >54% or KIR-negative >72%) provided optimal discrimination between NK-cell neoplasm cases and healthy donor controls with an accuracy of 100% compared with the clinicopathologic diagnosis. The selected rules were applied to 62 consecutive samples received in our flow cytometry laboratory that were reflexed to an NK-cell panel due to an expanded NK-cell percentage (exceeding 40% of total lymphocytes). Twenty-two (35%) of 62 samples were found to harbor a very small NK-cell population with restricted NK-cell receptor expression based on the rule combination, suggestive of NK-cell clonality. A thorough clinicopathologic evaluation for the 62 patients did not reveal diagnostic features of NK-cell neoplasms; therefore, these potential clonal populations of NK cells were designated as NK-cell clones of uncertain significance (NK-CUS). In this study, we established decision rules for NK-cell receptor restriction from the largest published cohorts of healthy donors and NK-cell neoplasms. The presence of small NK-cell populations with restricted NK-cell receptors does not appear to be an uncommon finding, and its significance requires further exploration.
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Affiliation(s)
- Jansen N Seheult
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Gregory E Otteson
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Dragan Jevremovic
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Pedro Horna
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Michael M Timm
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Ji Yuan
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - William G Morice
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Horatiu Olteanu
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Min Shi
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
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Kricke S, Rao K, Adams S. The significance of mixed chimaerism and cell lineage chimaerism monitoring in paediatric patients post haematopoietic stem cell transplant. Br J Haematol 2022; 198:625-640. [PMID: 35421255 DOI: 10.1111/bjh.18190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 11/28/2022]
Abstract
Haematopoietic stem cell transplants (HSCTs) are carried out across the world to treat haematological and immunological diseases which would otherwise prove fatal. Certain diseases are predominantly encountered in paediatric patients, such severe primary immunodeficiencies (PID) and diseases of inborn errors of metabolism (IEM). Chimaerism testing for these disorders has different considerations compared to adult diseases. This review focuses on the importance of cell-lineage-specific chimaerism testing and examines the appropriate cell populations to be assessed in individual paediatric patient groups. By analysing disease-associated subpopulations, abnormalities are identified significantly earlier than in whole samples and targeted clinical decisions can be made. Chimaerism methods have evolved over time and lead to an ever-increasing level of sensitivity and biomarker arrays to distinguish between recipient and donor cells. Short tandem repeat (STR) is still the gold standard for routine chimaerism assessment, and hypersensitive methods such as quantitative and digital polymerase chain reaction (PCR) are leading the forefront of microchimaerism testing. The rise of molecular methods operating with minute DNA amounts has been hugely beneficial to chimaerism testing of paediatric samples. As HSCTs are becoming increasingly personalised and risk-adjusted towards a child's individual needs, chimaerism testing needs to adapt alongside these medical advances ensuring the best possible care.
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Affiliation(s)
- Susanne Kricke
- Specialist Integrated Haematology and Malignancy Diagnostic Service, Department of Haematology, Great Ormond Street Hospital for Children, London, UK
| | - Kanchan Rao
- Department of Blood and Marrow Transplantation, Great Ormond Street Hospital for Children, London, UK
| | - Stuart Adams
- Specialist Integrated Haematology and Malignancy Diagnostic Service, Department of Haematology, Great Ormond Street Hospital for Children, London, UK
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DiGiuseppe JA. Issue Highlights-March 2022. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2022; 102:85-87. [PMID: 35293132 DOI: 10.1002/cyto.b.22064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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OUP accepted manuscript. Lab Med 2022; 53:417-425. [DOI: 10.1093/labmed/lmac014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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9
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Muñoz-García N, Lima M, Villamor N, Morán-Plata FJ, Barrena S, Mateos S, Caldas C, Balanzategui A, Alcoceba M, Domínguez A, Gómez F, Langerak AW, van Dongen JJM, Orfao A, Almeida J. Anti-TRBC1 Antibody-Based Flow Cytometric Detection of T-Cell Clonality: Standardization of Sample Preparation and Diagnostic Implementation. Cancers (Basel) 2021; 13:cancers13174379. [PMID: 34503189 PMCID: PMC8430560 DOI: 10.3390/cancers13174379] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022] Open
Abstract
A single antibody (anti-TRBC1; JOVI-1 antibody clone) against one of the two mutually exclusive T-cell receptor β-chain constant domains was identified as a potentially useful flow-cytometry (FCM) marker to assess Tαβ-cell clonality. We optimized the TRBC1-FCM approach for detecting clonal Tαβ-cells and validated the method in 211 normal, reactive and pathological samples. TRBC1 labeling significantly improved in the presence of CD3. Purified TRBC1+ and TRBC1- monoclonal and polyclonal Tαβ-cells rearranged TRBJ1 in 44/47 (94%) and TRBJ1+TRBJ2 in 48 of 48 (100%) populations, respectively, which confirmed the high specificity of this assay. Additionally, TRBC1+/TRBC1- ratios within different Tαβ-cell subsets are provided as reference for polyclonal cells, among which a bimodal pattern of TRBC1-expression profile was found for all TCRVβ families, whereas highly-variable TRBC1+/TRBC1- ratios were observed in more mature vs. naïve Tαβ-cell subsets (vs. total T-cells). In 112/117 (96%) samples containing clonal Tαβ-cells in which the approach was validated, monotypic expression of TRBC1 was confirmed. Dilutional experiments showed a level of detection for detecting clonal Tαβ-cells of ≤10-4 in seven out of eight pathological samples. These results support implementation of the optimized TRBC1-FCM approach as a fast, specific and accurate method for assessing T-cell clonality in diagnostic-FCM panels, and for minimal (residual) disease detection in mature Tαβ+ leukemia/lymphoma patients.
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Affiliation(s)
- Noemí Muñoz-García
- Translational and Clinical Research Program, Centro de Investigación del Cáncer and IBMCC (CSIC-University of Salamanca), Cytometry Service, NUCLEUS, Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (N.M.-G.); (F.J.M.-P.); (S.B.); (S.M.); (C.C.); (A.O.)
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain; (N.V.); (A.B.); (M.A.)
| | - Margarida Lima
- Department of Hematology, Laboratory of Cytometry, Hospital de Santo António, Centro Hospitalar do Porto, 4099-001 Porto, Portugal;
- Unit for Multidisciplinary Research in Biomedicine (UMIB), Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal
| | - Neus Villamor
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain; (N.V.); (A.B.); (M.A.)
- Department of Pathology, Hematopathology Unit, Hospital Clínic, IDIBAPS, 08036 Barcelona, Spain
| | - F. Javier Morán-Plata
- Translational and Clinical Research Program, Centro de Investigación del Cáncer and IBMCC (CSIC-University of Salamanca), Cytometry Service, NUCLEUS, Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (N.M.-G.); (F.J.M.-P.); (S.B.); (S.M.); (C.C.); (A.O.)
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain; (N.V.); (A.B.); (M.A.)
| | - Susana Barrena
- Translational and Clinical Research Program, Centro de Investigación del Cáncer and IBMCC (CSIC-University of Salamanca), Cytometry Service, NUCLEUS, Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (N.M.-G.); (F.J.M.-P.); (S.B.); (S.M.); (C.C.); (A.O.)
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain; (N.V.); (A.B.); (M.A.)
| | - Sheila Mateos
- Translational and Clinical Research Program, Centro de Investigación del Cáncer and IBMCC (CSIC-University of Salamanca), Cytometry Service, NUCLEUS, Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (N.M.-G.); (F.J.M.-P.); (S.B.); (S.M.); (C.C.); (A.O.)
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain; (N.V.); (A.B.); (M.A.)
| | - Carolina Caldas
- Translational and Clinical Research Program, Centro de Investigación del Cáncer and IBMCC (CSIC-University of Salamanca), Cytometry Service, NUCLEUS, Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (N.M.-G.); (F.J.M.-P.); (S.B.); (S.M.); (C.C.); (A.O.)
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain; (N.V.); (A.B.); (M.A.)
| | - Ana Balanzategui
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain; (N.V.); (A.B.); (M.A.)
- Hematology Service, University Hospital of Salamanca, Translational and Clinical Research Program, Centro de Investigación del Cáncer/IBMCC and IBSAL, 37007 Salamanca, Spain
| | - Miguel Alcoceba
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain; (N.V.); (A.B.); (M.A.)
- Hematology Service, University Hospital of Salamanca, Translational and Clinical Research Program, Centro de Investigación del Cáncer/IBMCC and IBSAL, 37007 Salamanca, Spain
| | - Alejandro Domínguez
- Centro de Salud Miguel Armijo, Sanidad de Castilla y León (SACYL), 37007 Salamanca, Spain; (A.D.); (F.G.)
| | - Fabio Gómez
- Centro de Salud Miguel Armijo, Sanidad de Castilla y León (SACYL), 37007 Salamanca, Spain; (A.D.); (F.G.)
| | - Anton W. Langerak
- Department of Immunology, Laboratory Medical immunology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands;
| | - Jacques J. M. van Dongen
- Department of Immunology, Leiden University Medical Center (LUMC), 2333 ZA Leiden, The Netherlands;
| | - Alberto Orfao
- Translational and Clinical Research Program, Centro de Investigación del Cáncer and IBMCC (CSIC-University of Salamanca), Cytometry Service, NUCLEUS, Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (N.M.-G.); (F.J.M.-P.); (S.B.); (S.M.); (C.C.); (A.O.)
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain; (N.V.); (A.B.); (M.A.)
| | - Julia Almeida
- Translational and Clinical Research Program, Centro de Investigación del Cáncer and IBMCC (CSIC-University of Salamanca), Cytometry Service, NUCLEUS, Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (N.M.-G.); (F.J.M.-P.); (S.B.); (S.M.); (C.C.); (A.O.)
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain; (N.V.); (A.B.); (M.A.)
- Correspondence:
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Lanza F, Maffini E. ISSUE HIGHLIGHTS - July 2020. CYTOMETRY PART B-CLINICAL CYTOMETRY 2021; 98:295-298. [PMID: 32687692 DOI: 10.1002/cyto.b.21937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Francesco Lanza
- Hematology Unit and Romagna Transplant Network, Ravenna & Ferrara University, Italy
| | - Enrico Maffini
- Hematology Unit and Romagna Transplant Network, Ravenna & Ferrara University, Italy
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Horna P, Shi M, Olteanu H, Johansson U. Emerging Role of T-cell Receptor Constant β Chain-1 (TRBC1) Expression in the Flow Cytometric Diagnosis of T-cell Malignancies. Int J Mol Sci 2021; 22:ijms22041817. [PMID: 33673033 PMCID: PMC7918842 DOI: 10.3390/ijms22041817] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023] Open
Abstract
T-cell clonality testing is integral to the diagnostic work-up of T-cell malignancies; however, current methods lack specificity and sensitivity, which can make the diagnostic process difficult. The recent discovery of a monoclonal antibody (mAb) specific for human TRBC1 will greatly improve the outlook for T-cell malignancy diagnostics. The anti-TRBC1 mAb can be used in flow cytometry immunophenotyping assays to provide a low-cost, robust, and highly specific test that detects clonality of immunophenotypically distinct T-cell populations. Recent studies demonstrate the clinical utility of this approach in several contexts; use of this antibody in appropriately designed flow cytometry panels improves detection of circulating disease in patients with cutaneous T-cell lymphoma, eliminates the need for molecular clonality testing in the context of large granular lymphocyte leukemia, and provides more conclusive results in the context of many other T-cell disorders. It is worth noting that the increased ability to detect discrete clonal T-cell populations means that identification of T-cell clones of uncertain clinical significance (T-CUS) will become more common. This review discusses this new antibody and describes how it defines clonal T-cells. We present and discuss assay design and summarize findings to date about the use of flow cytometry TRBC1 analysis in the field of diagnostics, including lymph node and fluid sample investigations. We also make suggestions about how to apply the assay results in clinical work-ups, including how to interpret and report findings of T-CUS. Finally, we highlight areas that we think will benefit from further research.
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Affiliation(s)
- Pedro Horna
- Division of Hematopathology, Mayo Clinic, Rochester, MN 55905, USA; (P.H.); (M.S.); (H.O.)
| | - Min Shi
- Division of Hematopathology, Mayo Clinic, Rochester, MN 55905, USA; (P.H.); (M.S.); (H.O.)
| | - Horatiu Olteanu
- Division of Hematopathology, Mayo Clinic, Rochester, MN 55905, USA; (P.H.); (M.S.); (H.O.)
| | - Ulrika Johansson
- SI-HMDS, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol BS1 3NU, UK
- Correspondence:
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12
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Vermeer MH, Nicolay JP, Scarisbrick JJ, Zinzani PL. The importance of assessing blood tumour burden in cutaneous T-cell lymphoma. Br J Dermatol 2021; 185:19-25. [PMID: 33155285 PMCID: PMC8359272 DOI: 10.1111/bjd.19669] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 12/28/2022]
Abstract
Mycosis fungoides (MF) and Sézary syndrome (SS) are the best-studied subtypes of cutaneous T-cell lymphoma. The level of blood tumour burden in patients is important for diagnosis, disease staging, prognosis and management, as well as assessing treatment response. Until recently, the assessment of blood involvement was made using manual counts of morphologically atypical T cells (Sézary cells), but this approach may be subjective, and is affected by interobserver variability. Objective and consistent approaches to accurately quantifying blood involvement are required to ensure appropriate stage-related management of patients and to improve our understanding of the prognostic implications of blood tumour burden in these diseases. While assessment of blood involvement is common in SS and advanced-stage MF, an improved understanding of the implications of blood involvement at early disease stages could help identify patients more likely to progress to late-stage disease, and hence guide treatment decisions and frequency of follow-up assessment, ultimately improving patient outcomes. This concise review discusses the development of flow cytometry-based classifications for assessing blood involvement in MF and SS, and summarizes current recommendations for blood classification and assessment of blood response to treatment.
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Affiliation(s)
- M H Vermeer
- Leiden University Medical Center, Leiden, the Netherlands
| | - J P Nicolay
- Department of Dermatology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.,Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Section of Clinical and Experimental Dermatology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - P L Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Istituto di Ematologia 'Seràgnoli', Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università degli Studi, Bologna, Italy
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13
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Liu S, Rice L, Ewton A. Reactive NK cell lymphocytosis with atypical immunophenotype in a chronic HIV-infected patient. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:240-242. [PMID: 33211408 DOI: 10.1002/cyto.b.21969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 10/03/2020] [Accepted: 10/15/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Shujuan Liu
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA
| | - Lawrence Rice
- Division of Hematology, Department of Medicine, and Cancer Center, Houston Methodist Hospital, Houston, Texas, USA
| | - April Ewton
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA
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14
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Illingworth A, Johansson U, Huang S, Horna P, Wang SA, Almeida J, Wolniak KL, Psarra K, Torres R, Craig FE. International guidelines for the flow cytometric evaluation of peripheral blood for suspected Sézary syndrome or mycosis fungoides: Assay development/optimization, validation, and ongoing quality monitors. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:156-182. [PMID: 33112044 DOI: 10.1002/cyto.b.21963] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 12/23/2022]
Abstract
Introducing a sensitive and specific peripheral blood flow cytometric assay for Sézary syndrome and mycosis fungoides (SS/MF) requires careful selection of assay design characteristics, and translation into a laboratory developed assay through development/optimization, validation, and continual quality monitoring. As outlined in a previous article in this series, the recommended design characteristics of this assay include at a minimum, evaluation of CD7, CD3, CD4, CD8, CD26, and CD45, analyzed simultaneously, requiring at least a 6 color flow cytometry system, with both quantitative and qualitative components. This article provides guidance from an international group of cytometry specialists in implementing an assay to those design specifications, outlining specific considerations, and best practices. Key points presented in detail are: (a) Pre-analytic components (reagents, specimen processing, and acquisition) must be optimized to: (i) identify and characterize an abnormal population of T-cells (qualitative component) and (ii) quantitate the abnormal population (semi/quasi-quantitative component). (b)Analytic components (instrument set-up/acquisition/analysis strategy and interpretation) must be optimized for the identification of SS/MF populations, which can vary widely in phenotype. Comparison with expert laboratories is strongly encouraged in order to establish competency. (c) Assay performance must be validated and documented through a validation plan and report, which covers both qualitative and semi/quasi-quantitative assay components (example template provided). (d) Ongoing assay-specific quality monitoring should be performed to ensure consistency.
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Affiliation(s)
- Andrea Illingworth
- Flow Cytometry Division, Dahl-Chase Diagnostic Services, Bangor, Maine, USA
| | - Ulrika Johansson
- SI-HMDS, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Pedro Horna
- Division of Hematopathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Sa A Wang
- Department of Hematopathology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Julia Almeida
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL); Cytometry Service (NUCLEUS) and Department of Medicine, IBSAL and CIBERONC, University of Salamanca, Salamanca, Spain
| | - Kristy L Wolniak
- Division of Hematopathology, Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Katherina Psarra
- Department of Immunology - Histocompatibility, "Evangelismos" Hospital, Athens, Greece
| | - Richard Torres
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Fiona E Craig
- Division of Hematopathology, Mayo Clinic Arizona, Phoenix, Arizona, USA
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15
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Utility of TRBC1 Expression in the Diagnosis of Peripheral Blood Involvement by Cutaneous T-Cell Lymphoma. J Invest Dermatol 2020; 141:821-829.e2. [PMID: 33049270 DOI: 10.1016/j.jid.2020.09.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/24/2020] [Accepted: 09/23/2020] [Indexed: 12/23/2022]
Abstract
Peripheral blood involvement by cutaneous T-cell lymphoma is typically assessed by flow cytometry and plays a critical role in diagnosis, classification, and prognosis. Simplified strategies to detect tumor cells (Sezary cells) fail to exclude reactive subsets, whereas tumor-specific abnormalities are subtle and inconsistently present. We implemented a flow cytometric strategy to detect clonal Sezary cells based on the monotypic expression of one of two mutually exclusive TCR constant β chains, TRBC1 and TRBC2. Analysis of CD4+ T-cell subsets and TCR variable β classes from healthy donors showed polytypic TRBC1 staining. Clonal Sezary cells were identified by TRBC1 staining in 56 of 111 (50%) samples from patients with cutaneous T-cell lymphoma, accounting for 7-18,155 cells/μl and including 13 cases (23%) lacking tumor-specific immunophenotypic abnormalities. CD4+ T-cell subsets from 86 patients without T-cell lymphoma showed polytypic TRBC1 staining, except for five patients (6%) with minute T-cell clones of uncertain significance accounting for 53-136 cells/μl. Assessment of TRBC1 expression within a comprehensive single-tube flow cytometry assay effectively overcomes interpretative uncertainties in the identification of Sezary cells without the need for a separate T-cell clonality assay.
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16
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Keyes TJ, Domizi P, Lo YC, Nolan GP, Davis KL. A Cancer Biologist's Primer on Machine Learning Applications in High-Dimensional Cytometry. Cytometry A 2020; 97:782-799. [PMID: 32602650 PMCID: PMC7416435 DOI: 10.1002/cyto.a.24158] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 03/10/2020] [Accepted: 05/12/2020] [Indexed: 12/11/2022]
Abstract
The application of machine learning and artificial intelligence to high-dimensional cytometry data sets has increasingly become a staple of bioinformatic data analysis over the past decade. This is especially true in the field of cancer biology, where protocols for collecting multiparameter single-cell data in a high-throughput fashion are rapidly developed. As the use of machine learning methodology in cytometry becomes increasingly common, there is a need for cancer biologists to understand the basic theory and applications of a variety of algorithmic tools for analyzing and interpreting cytometry data. We introduce the reader to several keystone machine learning-based analytic approaches with an emphasis on defining key terms and introducing a conceptual framework for making translational or clinically relevant discoveries. The target audience consists of cancer cell biologists and physician-scientists interested in applying these tools to their own data, but who may have limited training in bioinformatics. © 2020 International Society for Advancement of Cytometry.
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Affiliation(s)
- Timothy J Keyes
- Medical Scientist Training Program, Stanford University School of Medicine, Stanford, California
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Pablo Domizi
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Yu-Chen Lo
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Garry P Nolan
- Department of Microbiology and Immunology | Baxter Laboratory for Stem Cell Biology, Stanford University School of Medicine, Stanford, California
| | - Kara L Davis
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
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17
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Lyapichev KA, Bah I, Huen A, Duvic M, Routbort MJ, Wang W, Jorgensen JL, Medeiros LJ, Vega F, Craig FE, Wang SA. Determination of immunophenotypic aberrancies provides better assessment of peripheral blood involvement by mycosis fungoides/Sézary syndrome than quantification of CD26- or CD7- CD4+ T-cells. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:183-191. [PMID: 32667737 DOI: 10.1002/cyto.b.21933] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/12/2020] [Accepted: 06/10/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Blood involvement by mycosis fungoides (MF)/Sézary syndrome (SS) influences prognosis and therapeutic decisions. MF/SS blood stage is currently determined by absolute CD4 + CD26- or CD4 + CD7-cell counts, which quantification method may overestimate MF/SS by including CD26- or CD7- normal CD4+ T-cells, or underestimate disease burden when MF/SS cells show incomplete loss of CD26 and/or CD7. Recently, through the standardization effort led by the International Clinical Cytometry Society (ICCS), recommendation was made to quantify MF/SS by enumerating immunophenotypically aberrant CD4+ T-cells, rather than CD26- or CD7- in isolation. METHODS We compared these two quantitation methods in 309 MF/SS patients who had blood samples analyzed by flow cytometry immunophenotyping (FCI) over a 1-year period. RESULTS Using the European Organization of Research and Treatment of Cancer (EORTC)/International Society for Cutaneous Lymphomas (ISCL) criteria, 221 (71.5%) patients had a blood stage corresponding to B0, 57 (18.4%) to B1, and 31 (10%) to B2. By FCI analysis, a total of 62 patients (20.0%) were found positive for MF/SS. Among EORTC B0 patients, 11/221 (5%) were positive by FCI (false negatives), and among EORTC Stage B1 patients, 35/57 (61%) were negative by FCI (false positives). Regarding patients positive for MF/SS cells by FCI, there was an overall excellent correlation (r = .999, p < .001) between the EORTC/ISCL method and FCI method; however, four (6.5%) patients would have an altered B stage between B0 and B1. CONCLUSION The MF/SS cell quantification method using immunophenotypic aberrancies, as recommended by the ICCS, allows to distinguish MF/SS cells from background benign T-cells and enables for more accurate staging, especially among patients currently being considered to have B0 and B1 stage diseases.
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Affiliation(s)
- Kirill A Lyapichev
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ismael Bah
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Auris Huen
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Madeleine Duvic
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mark J Routbort
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Wei Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jeffrey L Jorgensen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Francisco Vega
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Fiona E Craig
- Division of Hematopathology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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18
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Fu M, Mani M, Bradford J, Chen W, Chen M, Fuda F. Application of flow cytometry in the analysis of lymphoid disease in the lung and pleural space. Semin Diagn Pathol 2020; 37:303-320. [PMID: 32768250 DOI: 10.1053/j.semdp.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 06/23/2020] [Accepted: 06/23/2020] [Indexed: 11/11/2022]
Abstract
Various types of lymphoid neoplasms can occur in the lung. Lung parenchyma, the pleura or the pleural cavity can be the primary site of a lymphoid neoplasm or can be involved secondarily as a result of systemic dissemination from a separate primary site. Recognition of pulmonary lymphoid neoplasms (PLN) has increased secondary to technological advances in the medical field. Multiparameter flow cytometry (FC) is a one of the diagnostic tools that serves an essential role in the detecting and categorizing PLNs. FC allows for rapid identification and immunophenotypic characterization of PLN. In this article, we discuss the role of FC in the diagnosis of the most commonly encountered PLNs as well as their basic clinicopathologic features. We briefly discuss the role of FC in identifying non-hematolymphoid neoplasms in lung specimens as well.
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Affiliation(s)
- May Fu
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Malary Mani
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Jaclyn Bradford
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Weina Chen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Mingyi Chen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Franklin Fuda
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX.
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19
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Berg H, Otteson GE, Corley H, Shi M, Horna P, Jevremovic D, Olteanu H. Flow cytometric evaluation of
TRBC1
expression in tissue specimens and body fluids is a novel and specific method for assessment of
T‐cell
clonality and diagnosis of
T‐cell
neoplasms. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:361-369. [DOI: 10.1002/cyto.b.21881] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/31/2020] [Accepted: 04/07/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Holly Berg
- Division of Hematopathology, Department of Pathology and Laboratory Medicine Mayo Clinic Rochester Minnesota USA
| | - Gregory E. Otteson
- Division of Hematopathology, Department of Pathology and Laboratory Medicine Mayo Clinic Rochester Minnesota USA
| | - Heidi Corley
- Division of Hematopathology, Department of Pathology and Laboratory Medicine Mayo Clinic Rochester Minnesota USA
| | - Min Shi
- Division of Hematopathology, Department of Pathology and Laboratory Medicine Mayo Clinic Rochester Minnesota USA
| | - Pedro Horna
- Division of Hematopathology, Department of Pathology and Laboratory Medicine Mayo Clinic Rochester Minnesota USA
| | - Dragan Jevremovic
- Division of Hematopathology, Department of Pathology and Laboratory Medicine Mayo Clinic Rochester Minnesota USA
| | - Horatiu Olteanu
- Division of Hematopathology, Department of Pathology and Laboratory Medicine Mayo Clinic Rochester Minnesota USA
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20
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Gratama JW. Issue Highlights - March 2019. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 96:93-95. [PMID: 30884160 DOI: 10.1002/cyto.b.21778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/05/2019] [Accepted: 02/28/2019] [Indexed: 11/09/2022]
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21
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Craig FE. It is time to adopt a multicolor immunophenotyping approach to evaluate blood for Sézary syndrome and mycosis fungoides. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:125-128. [PMID: 32083391 DOI: 10.1002/cyto.b.21872] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/27/2020] [Accepted: 02/03/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Fiona E Craig
- Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, Arizona
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22
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Li YL, Wang HP, Zhang C, Zhai ZM. CD20-positive primary nasal peripheral T-cell lymphoma: An analysis of one case and review of the literature. CYTOMETRY PART B-CLINICAL CYTOMETRY 2019; 98:348-354. [PMID: 31682318 DOI: 10.1002/cyto.b.21852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/27/2019] [Accepted: 10/08/2019] [Indexed: 01/01/2023]
Abstract
CD20-positive T-cell lymphoma (TCL) is a very rare disease entity that is associated with the co-expressions of a range of T cell lineage makers, such as, CD2, CD3, CD5, or CD7, and CD20. The biological and clinical significance of CD20 antigen expressed in TCL has been unclear. Here, we are reporting an unusual case of CD20-positive primary nasal peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) in a 62-year-old female with both peripheral blood (PB) and bone marrow (BM) involvement. Flow cytometry (FC) analysis revealed CD20+ lymphoma cells in PB, BM, and lymph node (LN) and was consistent with pathological findings. FC immunophenotyping was proved of great diagnostic contribution.
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Affiliation(s)
- Yan-Li Li
- Department of Pathology, Anhui Medical University, Hefei, Anhui, People's Republic of China.,Department of Pathology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Hui-Ping Wang
- Department of Hematology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Cui Zhang
- Department of Hematology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Zhi-Min Zhai
- Department of Hematology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
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