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Lorenzi L, Lonardi S, Bonezzi M, Zini S, Bugatti M, Valzelli A, Melotti F, Facchetti M, Ghini I, Villanacci V, Balzarini P, Pizzi M, Giustini V, Galvagni A, Chiarini M, Dei Tos AP, Vermi W, Casola S, Facchetti F. Immunoglobulin light chain transcript detection by ultrasensitive RNA in situ hybridization for B-cell lymphoma diagnosis. Virchows Arch 2024; 485:43-51. [PMID: 37884676 DOI: 10.1007/s00428-023-03682-8] [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: 05/22/2023] [Revised: 10/06/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023]
Abstract
Evaluation of B-cell clonality can be challenging in the interpretation of lymphoid infiltrates on tissue sections. Clonality testing based on IG gene rearrangements analysis by PCR (IG-PCR) is the gold standard. Alternatively, B-cell clonality can be assessed by the recognition of immunoglobulin light chain (IgLC) restriction, by immunohistochemistry (IHC), chromogenic in situ hybridization (ISH) or flow cytometry (FC). IG-PCR requires molecular facilities, and FC requires cell suspensions, both not widely available in routine pathology units. This study evaluates the performance of B-cell clonality detection by IgLC-RNAscope® (RNAsc) in a group of 216 formalin-fixed, paraffin-embedded samples including 185 non-Hodgkin B-cell lymphomas, 11 Hodgkin lymphomas (HL) and 20 reactive samples. IgLC-RNAsc, performed in parallel with FC in 53 cases, demonstrated better performances (93% vs 83%), particularly in diffuse large B-cell lymphoma (98% vs 71%) and follicular lymphoma (93% vs 83%) diagnosis. IgLC-RNAsc was also superior to IHC and ISH especially in samples with limited tumor cell content, where IG-PCR was not informative. Performed for the first time on mediastinal lymphomas, IgLC-RNAsc identified monotypic IgLC transcripts in 69% of primary mediastinal large B-cell lymphoma (PMBCL) and 67% of mediastinal gray zone lymphomas (MGZL). IGK/L double-negative cells were detected in 1 PMBCL, 2 MGZL, and all classical HL, while monotypic IgLC expression appeared to be a hallmark in nodular lymphocyte-predominant HL. IgLC-RNAsc demonstrates to be a powerful tool in B-cell lymphoma diagnosis, above all in challenging cases with limited tumor cell content, ensuring in situ investigations on mechanisms of Ig regulation across lymphoma entities.
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Affiliation(s)
- Luisa Lorenzi
- Pathology Unit, Department of Molecular and Translational Medicine-DMMT, University of Brescia, Brescia, Italy.
- Pathology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy.
| | - Silvia Lonardi
- Pathology Unit, Department of Molecular and Translational Medicine-DMMT, University of Brescia, Brescia, Italy
| | - Michela Bonezzi
- Pathology Unit, Department of Molecular and Translational Medicine-DMMT, University of Brescia, Brescia, Italy
| | - Stefania Zini
- Pathology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
| | - Mattia Bugatti
- Pathology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
| | - Arianna Valzelli
- Pathology Unit, Department of Molecular and Translational Medicine-DMMT, University of Brescia, Brescia, Italy
| | - Flavia Melotti
- Pathology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
| | | | - Iacopo Ghini
- Pathology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
| | | | - Piera Balzarini
- Pathology Unit, Department of Molecular and Translational Medicine-DMMT, University of Brescia, Brescia, Italy
- Pathology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
| | - Marco Pizzi
- Pathology Department, Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua School of Medicine, Padua, Italy
| | - Viviana Giustini
- Flow Cytometry Unit, Clinical Chemistry Laboratory, ASST Spedali Civili Di Brescia, Brescia, Italy
| | - Anna Galvagni
- Flow Cytometry Unit, Clinical Chemistry Laboratory, ASST Spedali Civili Di Brescia, Brescia, Italy
| | - Marco Chiarini
- Flow Cytometry Unit, Clinical Chemistry Laboratory, ASST Spedali Civili Di Brescia, Brescia, Italy
| | - Angelo Paolo Dei Tos
- Pathology Department, Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua School of Medicine, Padua, Italy
| | - William Vermi
- Pathology Unit, Department of Molecular and Translational Medicine-DMMT, University of Brescia, Brescia, Italy
- Pathology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
| | - Stefano Casola
- IFOM-ETS-The AIRC Institute of Molecular Oncology, Milan, Italy
| | - Fabio Facchetti
- Pathology Unit, Department of Molecular and Translational Medicine-DMMT, University of Brescia, Brescia, Italy
- Pathology Unit, ASST Spedali Civili Di Brescia, Brescia, Italy
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Gao Q, Chen X, Cherian S, Roshal M. Mature B‐ and plasma‐cell flow cytometric analysis: A review of the impact of targeted therapy. CYTOMETRY PART B: CLINICAL CYTOMETRY 2022; 104:224-242. [PMID: 36321879 DOI: 10.1002/cyto.b.22097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/04/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
Flow cytometry has been indispensable in diagnosing B cell lymphoma and plasma cell neoplasms. The advances in novel multicolor flow cytometry have also made this technology a robust tool for monitoring minimal/measurable residual disease in chronic lymphocytic leukemia and multiple myeloma. However, challenges using conventional gating strategies to isolate neoplastic B or plasma cells are emerging due to the rapidly increasing number of antibody therapeutics targeting single or multiple classic B/plasma cell-lineage markers, such as CD19, CD20, and CD22 in B cells and CD38 in plasma cells. This review is the first of a two-part series that summarizes the most current targeted therapies used in B and plasma cell neoplasms and proposes detailed alternative approaches to overcome post-targeted therapy analysis challenges by flow cytometry. The second review in this series (Chen et al.) focuses on challenges encountered in the use of targeted therapy in precursor B cell neoplasms.
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Affiliation(s)
- Qi Gao
- Hematopathology Service, Department of Pathology and Laboratory Medicine Memorial Sloan Kettering Cancer Center New York New York USA
| | - Xueyan Chen
- Department of Laboratory Medicine and Pathology University of Washington Seattle WA USA
| | - Sindu Cherian
- Department of Laboratory Medicine and Pathology University of Washington Seattle WA USA
| | - Mikhail Roshal
- Hematopathology Service, Department of Pathology and Laboratory Medicine Memorial Sloan Kettering Cancer Center New York New York USA
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Nakaya Y, Sakaida M, Yoshida M, Shimizu K, Yagi N, Tsutsumi M, Yoshimura T, Hayashi Y, Nakao T, Inoue T, Yamane T. Clinicopathological analysis of diffuse large B-cell lymphoma lacking surface immunoglobulin light chain restriction on flow cytometry. J Clin Exp Hematop 2021; 62:9-17. [PMID: 34707034 PMCID: PMC9010494 DOI: 10.3960/jslrt.21017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Although diffuse large B-cell lymphoma (DLBCL) occasionally lacks surface immunoglobulin light chain restriction (iLCR) on flow cytometry (FCM), little evidence is available for iLCR-negative DLBCL. We retrospectively compared clinicopathological features of iLCR-positive and iLCR-negative DLBCL diagnosed at our institute between April 2007 and March 2018. iLCR-positive was defined as a κ/λ ratio less than 0.5 or greater than 3 in the gated population on dual-color FCM, and iLCR-negative as other values. Of 81 DLBCL cases with available immunophenotyping by FCM, 63 iLCR-positive DLBCL (78%) and 18 iLCR-negative DLBCL (22%) cases were identified. Survival outcomes of patients with iLCR-negative DLBCL were comparable with those of patients with iLCR-positive DLBCL. Pathological analysis revealed no significant difference except for the lower expression of BCL6 in iLCR-negative DLBCL (12.5% vs 65.5%, p < 0.001), although there was a slightly higher frequency of necrosis (47.1% vs 20.7%, p = 0.058) and lower expression of CD10 (11.8% vs 35.0%, p = 0.078) in iLCR-negative DLBCL than in iLCR-positive DLBCL. The underlying mechanism remains unclear; however, low expression of germinal center markers and tumor necrosis may be associated with the loss of iLCR in DLBCL.
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Affiliation(s)
- Yosuke Nakaya
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Miho Sakaida
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
| | - Masahiro Yoshida
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Katsujun Shimizu
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Naoko Yagi
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Minako Tsutsumi
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Takuro Yoshimura
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Yoshiki Hayashi
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Takafumi Nakao
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Takeshi Inoue
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
| | - Takahisa Yamane
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
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Wang W, Li Y, Rivera Rivera X, Zhao L, Mei D, Hu W, Jiang B. Application of CD54 in diagnosing bone marrow involvement by using flow cytometry in patients with diffuse large B-cell lymphoma. BMC Cancer 2021; 21:1011. [PMID: 34503477 PMCID: PMC8431857 DOI: 10.1186/s12885-021-08753-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/01/2021] [Indexed: 11/14/2022] Open
Abstract
Background Flow cytometry plays a key role in detecting bone marrow (BM) involvement in patients with diffuse large B-cell lymphoma (DLBCL). To improve its detection sensitivity, we need to explore novel markers. In this study, we detected the expression CD54 on lymphoma cells in BM specimens from DLBCL patients and clarified its diagnostic significance in BM involvement by DLBCL. Methods We collected BM specimens from 76 patients with DLBCL (germinal center B-cell (GCB) = 25, non-GCB = 51) and 10 control patients without lymphoma. We detected and compared the expression of CD54 on lymphoma cells and normal mature B cells by using 10-color panels. Results Normal plasma cells expressed a higher level of CD54 as compared with hematogones (p < 0.05) and normal mature B cells (p < 0.05). Among 76 patients, 23 of them (GCB = 12, non-GCB = 11) had BM involvement. Lymphoma B cells from 12 cases (GBC = 4, non-GCB = 8) expressed a higher level of CD54 compared to normal mature B cells (p < 0.05). Additionally, lymphoma cells of the non-GCB subtype frequently expressed a higher level of CD54 in comparison to the GCB subtype (p < 0.05). And the high expression of CD54 was not related to plasmacytoid differentiation. Conclusion Aberrant expression of CD54 on lymphoma cells is frequently seen in patients’ BM specimens involved by DLBCL, especially in the non-GCB subtype. CD54 could be used as a new marker to gate on lymphoma cells and improve the detection sensitivity of BM involvement in patients with DLBCL. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08753-0.
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Affiliation(s)
- Wei Wang
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, Texas, USA
| | - Yan Li
- Department of Hematology, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Xavier Rivera Rivera
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, Texas, USA
| | - Linjun Zhao
- Department of Lymphoma, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Di Mei
- Department of Lymphoma, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Wenqing Hu
- Department of Hematology, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Bin Jiang
- Department of Hematology, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China.
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Nakagawa Y, Hamada T, Takahashi T, Miyake T, Hirai Y, Iwatsuki K, Morizane S. Analysis of clonality in cutaneous B-cell lymphoma and B-cell pseudolymphoma using skin flow cytometry: Comparison of immunophenotyping and gene rearrangement studies. J Dermatol 2021; 49:246-252. [PMID: 34263482 DOI: 10.1111/1346-8138.16057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 06/18/2021] [Accepted: 06/19/2021] [Indexed: 01/13/2023]
Abstract
To identify clonal neoplastic cells in skin affected by B-cell lymphoma using skin flow cytometry (FCM) techniques, we investigated light-chain restriction using skin FCM with clonality assessed by polymerase chain reaction and light-chain restriction by in situ hybridization (ISH). We retrospectively analyzed 16 cases of B-cell lymphoma with cutaneous involvement: primary cutaneous diffuse large B-cell lymphoma, leg type (pcDLBCL-LT) (n = 7), DLBCL-not otherwise specified (DLBCL-NOS) (n = 6), primary cutaneous follicle center lymphoma (pcFCL) (n = 1), and follicular lymphoma (n = 2), as well as cutaneous B-cell pseudolymphoma (n = 9). Results of skin FCM light-chain restriction analyses were compared with immunoglobulin H (IgH) gene rearrangement and κ/λ ISH findings. Skin FCM detected light-chain restriction in 11 of 14 B-cell lymphoma patients but none of the B-cell pseudolymphoma patients. The sensitivity of skin FCM for distinguishing B-cell lymphoma and B-cell pseudolymphoma was 79%, and the specificity was 100%. Eleven of 13 B-cell lymphoma patients exhibited gene rearrangement (sensitivity 85%), whereas six of seven pseudolymphoma patients were negative (specificity 86%). ISH was positive in three of 16 B-cell lymphoma cases (sensitivity 19%) but none of the B-cell pseudolymphoma cases (specificity 100%). ISH sensitivity was 29% for pcDLBCL-LT, 17% for DLBCL-NOS, and 0% for pcFCL and follicular lymphoma. Skin FCM therefore appears to be more sensitive than ISH in detecting light-chain restriction in DLBCL and follicular lymphoma, and as sensitive as IgH gene rearrangement analysis in detecting clonality. Skin FCM is thus a promising diagnostic tool for identifying monoclonal neoplastic B-cell populations.
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Affiliation(s)
- Yuki Nakagawa
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Toshihisa Hamada
- Department of Dermatology, Takamatsu Red Cross Hospital, Takamatsu, Japan
| | - Takahide Takahashi
- Division of Medical Support, Okayama University Hospital, Okayama, Japan
| | - Tomoko Miyake
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Yoji Hirai
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Keiji Iwatsuki
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
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Kroft SH, Sever CE, Bagg A, Billman B, Diefenbach C, Dorfman DM, Finn WG, Gratzinger DA, Gregg PA, Leonard JP, Smith S, Souter L, Weiss RL, Ventura CB, Cheung MC. Laboratory Workup of Lymphoma in Adults: Guideline From the American Society for Clinical Pathology and the College of American Pathologists. Arch Pathol Lab Med 2021; 145:269-290. [PMID: 33175094 DOI: 10.5858/arpa.2020-0261-sa] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— The diagnostic workup of lymphoma continues to evolve rapidly as experience and discovery led to the addition of new clinicopathologic entities and techniques to differentiate them. The optimal clinically effective, efficient, and cost-effective approach to diagnosis that is safe for patients can be elusive, in both community-based and academic practice. Studies suggest that there is variation in practice in both settings. OBJECTIVE.— To develop an evidence-based guideline for the preanalytic phase of testing, focusing on specimen requirements for the diagnostic evaluation of lymphoma. DESIGN.— The American Society for Clinical Pathology, the College of American Pathologists, and the American Society of Hematology convened a panel of experts in the laboratory workup of lymphoma to develop evidence-based recommendations. The panel conducted a systematic review of literature to address key questions. Using the Grading of Recommendations Assessment, Development, and Evaluation approach, recommendations were derived based on the available evidence, strength of that evidence, and key judgements as defined in the Grading of Recommendations Assessment, Development, and Evaluation Evidence to Decision framework. RESULTS.— Thirteen guideline statements were established to optimize specimen selection, ancillary diagnostic testing, and appropriate follow-up for safe and accurate diagnosis of indolent and aggressive lymphoma. CONCLUSIONS.— Primary diagnosis and classification of lymphoma can be achieved with a variety of specimens. Application of the recommendations can guide decisions on specimen suitability, diagnostic capabilities, and correct use of ancillary testing. Disease prevalence in patient populations, availability of ancillary testing, and diagnostic goals should be incorporated into algorithms tailored to each practice environment.
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Affiliation(s)
- Steven H Kroft
- From the Department of Pathology, Froedtert Hospital and the Medical Colleges of Wisconsin, Milwaukee (Kroft)
| | - Cordelia E Sever
- Pathology Associates of Albuquerque, Albuquerque, New Mexico (Sever)
| | - Adam Bagg
- The Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia (Bagg)
| | - Brooke Billman
- Governance Services (Billman), College of American Pathologists, Northfield, Illinois
| | - Catherine Diefenbach
- The Department of Medicine, New York University School of Medicine, New York, New York (Diefenbach)
| | - David M Dorfman
- The Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (Dorfman)
| | - William G Finn
- The Department of Pathology and Laboratory Medicine, Warde Medical Laboratory, Ann Arbor, Michigan (Finn)
| | - Dita A Gratzinger
- The Department of Pathology, Stanford Health Care, Stanford, California (Gratzinger)
| | - Patricia A Gregg
- The Department of Pathology, Lehigh Regional Medical Center, Lehigh Acres, Florida (Gregg)
| | - John P Leonard
- The Department of Hematology and Oncology, Weill Cornell Medical College, New York, New York (Leonard)
| | - Sonali Smith
- The Department of Medicine, University of Chicago Medicine, Chicago, Illinois (Smith)
| | - Lesley Souter
- Souter is in private practice in Wellandport, Ontario, Canada
| | - Ronald L Weiss
- The Department of Pathology, ARUP Laboratories Inc, Salt Lake City, Utah (Weiss)
| | - Christina B Ventura
- The Pathology and Laboratory Quality Center (Ventura), College of American Pathologists, Northfield, Illinois
| | - Matthew C Cheung
- The Department of Medicine, Odette Cancer Centre/Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Cheung)
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7
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Kroft SH, Sever CE, Bagg A, Billman B, Diefenbach C, Dorfman DM, Finn WG, Gratzinger DA, Gregg PA, Leonard JP, Smith S, Souter L, Weiss RL, Ventura CB, Cheung MC. Laboratory Workup of Lymphoma in Adults. Am J Clin Pathol 2021; 155:12-37. [PMID: 33219376 DOI: 10.1093/ajcp/aqaa191] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The diagnostic workup of lymphoma continues to evolve rapidly as experience and discovery lead to the addition of new clinicopathologic entities and techniques to differentiate them. The optimal clinically effective, efficient, and cost-effective approach to diagnosis that is safe for patients can be elusive, in both community-based and academic practice. Studies suggest that there is variation in practice in both settings. THE AIM OF THIS REVIEW IS TO develop an evidence-based guideline for the preanalytic phase of testing, focusing on specimen requirements for the diagnostic evaluation of lymphoma. METHODS The American Society for Clinical Pathology, the College of American Pathologists, and the American Society of Hematology convened a panel of experts in the laboratory workup of lymphoma to develop evidence-based recommendations. The panel conducted a systematic review of the literature to address key questions. Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, recommendations were derived based on the available evidence, the strength of that evidence, and key judgments as defined in the GRADE Evidence to Decision framework. RESULTS Thirteen guideline statements were established to optimize specimen selection, ancillary diagnostic testing, and appropriate follow-up for safe and accurate diagnosis of indolent and aggressive lymphoma. CONCLUSIONS Primary diagnosis and classification of lymphoma can be achieved with a variety of specimens. Application of the recommendations can guide decisions about specimen suitability, diagnostic capabilities, and correct utilization of ancillary testing. Disease prevalence in patient populations, availability of ancillary testing, and diagnostic goals should be incorporated into algorithms tailored to each practice environment.
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Affiliation(s)
- Steven H Kroft
- Department of Pathology, Froedtert Hospital and the Medical Colleges of Wisconsin, Milwaukee
| | | | - Adam Bagg
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia
| | - Brooke Billman
- Governance Services, College of American Pathologists, Northfield, IL
| | | | - David M Dorfman
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | - William G Finn
- Department of Pathology and Laboratory Medicine, Warde Medical Laboratory, Ann Arbor, MI
| | | | - Patricia A Gregg
- Dept of Pathology, Lehigh Regional Medical Center, Lehigh Acres, FL
| | - John P Leonard
- Department of Hematology and Oncology, Weill Cornell Medical College, New York, NY
| | - Sonali Smith
- Department of Medicine, The University of Chicago Medicine, Chicago, IL
| | | | - Ronald L Weiss
- Department of Pathology, ARUP Laboratories, Salt Lake City, UT
| | - Christina B Ventura
- Pathology and Laboratory Quality Center, College of American Pathologists, Northfield, IL
| | - Matthew C Cheung
- Department of Medicine, Odette Cancer Centre/Sunnybrook Health Sciences Centre, Toronto, Canada
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8
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Boyer DF, Choi S, Lee W, Carty S, Betz BL, Brown N, Lew M. Diagnostic Considerations in the Evaluation of Large B-Cells on Lymph Node Cytology Specimens. Acta Cytol 2020; 65:105-110. [PMID: 32882689 DOI: 10.1159/000510322] [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: 06/03/2020] [Accepted: 07/17/2020] [Indexed: 11/19/2022]
Abstract
Fine needle aspiration (FNA) has become increasingly popular in the evaluation of lymph nodes for lymphoproliferative disorders, but there are limitations to accurate subclassification of lymphoma using morphology alone. This case aims to expand diagnostic considerations of large B-cell populations identified on FNA material. We also address the significance of Epstein-Barr virus (EBV) DNA in the workup of patients with suspected lymphoma by FNA.
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Affiliation(s)
- Daniel F Boyer
- Department of Pathology, University of Michigan Hospital and Health System, Ann Arbor, Michigan, USA
| | - Sarah Choi
- Department of Pathology, University of Michigan Hospital and Health System, Ann Arbor, Michigan, USA
| | - Winston Lee
- Department of Pathology, University of Michigan Hospital and Health System, Ann Arbor, Michigan, USA
| | - Shannon Carty
- Department of Internal Medicine, University of Michigan Hospital and Health System, Ann Arbor, Michigan, USA
| | - Bryan L Betz
- Department of Pathology, University of Michigan Hospital and Health System, Ann Arbor, Michigan, USA
| | - Noah Brown
- Department of Pathology, University of Michigan Hospital and Health System, Ann Arbor, Michigan, USA
| | - Madelyn Lew
- Department of Pathology, University of Michigan Hospital and Health System, Ann Arbor, Michigan, USA,
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9
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Cytohistologic Features of Salivary Gland Lymphomas. ACTA ACUST UNITED AC 2020; 25:249-254. [PMID: 34017917 DOI: 10.1097/pcr.0000000000000404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Seegmiller AC, Hsi ED, Craig FE. The current role of clinical flow cytometry in the evaluation of mature B-cell neoplasms. CYTOMETRY PART B-CLINICAL CYTOMETRY 2018; 96:20-29. [PMID: 30549186 DOI: 10.1002/cyto.b.21756] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/14/2018] [Accepted: 11/15/2018] [Indexed: 12/18/2022]
Abstract
Flow cytometry (FC) has a well-established role in the diagnostic evaluation of mature B-cell neoplasms. Effective assessment for lineage associated antigens, aberrant antigen expression, and immunoglobulin light chain restriction requires a well-designed, optimized, and controlled FC assay. However, it is important for hematopathologists to know when flow cytometry has a more limited role, and other modalities, such as immunohistochemistry, cytogenetic and molecular testing, are more important. This review will discuss the features of an optimal FC assay for the evaluation of mature B-cell neoplasms, and the current role of FC in the diagnosis and sub-classification, prognostic assessment, identification of therapeutic targets, and assessment for disease response to therapy. © 2018 International Clinical Cytometry Society.
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Cozzolino I, Rocco M, Villani G, Picardi M. Lymph Node Fine-Needle Cytology of Non-Hodgkin Lymphoma: Diagnosis and Classification by Flow Cytometry. Acta Cytol 2016; 60:302-314. [PMID: 27554776 DOI: 10.1159/000448389] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 07/11/2016] [Indexed: 12/31/2022]
Abstract
In the last decades, lymph node fine-needle cytology (FNC), coupled with flow cytometry (FC), has gained a role in the diagnosis and classification of non-Hodgkin lymphoma (NHL). The combination of FNC/FC allows the diagnosis and classification of NHL in lymph node samples with a high sensitivity and specificity by combining cytological features and specific phenotypic profiles. The present review provides a brief technical description of FC and a detailed analysis of the current markers and their combinations (diagnostic algorithm) for the diagnosis and classification of NHL. The basic principles of clonality assessment, as well as the diagnostic strengths and weaknesses of the procedure, are reported. The current diagnostic algorithms for NHL classification are critically reviewed with a focus on specific problems related to single entities. Moreover, this review provides a detailed analysis of the different clinical contexts in which FNC/FC is performed and related implications. Future and further applications of FNC/FC for NHL are also discussed.
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