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Dufour JP, Allers C, Schiro F, Falkenstein KP, Gregoire KK, Glover CD, Chamel AN, Woods A, Phillippi JP, Gideon TM, Kaur A. Comparison of fine-needle aspiration techniques. J Med Primatol 2023; 52:400-404. [PMID: 37712216 PMCID: PMC10872887 DOI: 10.1111/jmp.12676] [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: 07/12/2023] [Revised: 08/25/2023] [Accepted: 09/03/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Fine-needle aspiration (FNA) has been reported since 1912 beginning with the use of trocars and other specialized instruments that were impractical. Since then, FNA has proven to be a successful alternative technique to excisional biopsy for some assays despite a few limitations. METHODS In this study, we compared four different techniques for FNA in rhesus macaques by evaluating total live cells recovered and cell viability using a standard 6 mL syringe and 1.5-inch 22-gauge needle. RESULTS Technique B which was the only technique in which the needle was removed from the syringe after collection of the sample to allow forced air through the needle to expel the contents into media followed by flushing of the syringe and needle resulted in the highest total cell count and second highest cell viability in recovered cells. CONCLUSION Based on our results, Technique B appears to be the superior method.
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Affiliation(s)
| | | | - Faith Schiro
- Tulane National Primate Research Center, Covington, LA
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Goel P, Acharya S, Ahuja S. Flowcytometry in Reactive Lymph Node Aspirates: Evaluation of Distribution of Populations with Immunophenotypic Outliers. Cytopathology 2022; 33:505-513. [PMID: 35023246 DOI: 10.1111/cyt.13098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/13/2021] [Accepted: 01/08/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Diagnostic accuracy of FNAC for lymphomas has markedly improved when used in conjunction with flowcytometry, especially to differentiate reactive lymph node aspirates from low-grade lymphomas, which is a challenge for cytopathologists. Lymphoma diagnosis by FCM depends on detection of immunophenotypic B and T cell outliers, which are also present in benign lymph nodes, albeit on a subset of cells. These can mimic heterogenous population obtained from lymphomas partially involving a lymph node. METHODS In the present study, flowcytometry of FNA/ scrape material from 30 cases of benign lymph nodes was evaluated to study the distribution of lymphoid populations and assess presence and percentages of immunophenotypic outliers. RESULTS Majority of lymph nodes sampled were cervical nodes with all cases showing a T cell predominance. CD5/CD19 coexpression was seen in 23.94 ± 9.51% of B cell events in 20 cases and CD10/CD19 coexpression was seen in 3.2% - 20.2% B cell events in 8 cases. None of the above cases showed a light chain restriction. Loss of CD7 (2-28.4% T cell events) and CD5 (12.7% of T cell events) expression was seen in 17 cases and one case respectively. CONCLUSION We concluded that immunophenotypic outliers suggestive of lymphomas could be seen in non-lymphomatous lymph node aspirates in a subset of population. However, they could be defined as benign due to absence of light chain restriction and normal CD4: CD8 ratio in all but one case in the present study. This case was confirmed to be benign after clinical correlation and excisional biopsy. Thus, multiparameter FCM along with clinicoradiological correlation can prevent overdiagnosis of lymphomas.
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Affiliation(s)
- Priyanka Goel
- Department of Pathology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttrakhand, India
| | - Seema Acharya
- Department of Pathology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttrakhand, India
| | - Sana Ahuja
- Department of Pathology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttrakhand, India
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Scott GD, Lau HD, Kurzer JH, Kong CS, Gratzinger DA. Flow immunophenotyping of benign lymph nodes sampled by FNA: Representative with diagnostic pitfalls. Cancer Cytopathol 2018; 126:797-808. [PMID: 30194715 PMCID: PMC6221160 DOI: 10.1002/cncy.22038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 05/31/2018] [Accepted: 06/21/2018] [Indexed: 11/08/2022]
Abstract
Background Fine‐needle aspiration with flow cytometry (FNA‐FC) is routinely used in the evaluation of lymph nodes suspicious for lymphoma, yet data comparing immunophenotype distributions and outliers in benign lymph nodes sampled by fine‐needle aspiration (FNA) versus excision are lacking. Methods Flow cytometry data from 289 benign lymph node FNA cases were assessed for the overall antigen distribution, with a focus on outliers relevant to the diagnosis of lymphoma. Distributions and outlier proportions were compared with those of a separate cohort of 298 excisional biopsies. Results Compared with excisional biopsies, FNA specimens overrepresented CD3+ events (72% vs 63%), underrepresented CD19+ events (22% vs 29%), and had 25% fewer large cell–gated events. Normalized antigen distributions in FNA were equivalent to those in excisional biopsy. Twenty‐three percent of FNA‐FC cases exhibited an outlier, including a skewed kappa:lambda light‐chain ratio, increased CD5+ or CD10+ B‐cell events, a skewed CD4:CD8 ratio, and increased CD7 loss on T cells, with no significant differences in frequency or type in comparison with excisional specimens. Outliers for the light‐chain ratio and T‐cell antigens were enriched among older patients and included patients with a variety of autoimmune/rheumatologic conditions. Conclusions Benign lymph node FNA yields flow immunophenotypes remarkably similar to those from excisional biopsies. Outlier flow immunophenotypes are identified in benign lymph nodes sampled by FNA at a frequency similar to that with excisional biopsies. Older patients, who have a higher baseline risk of lymphoma, are more likely to exhibit lymphoma‐mimicking outliers such as a light‐chain predominance on B cells and skewed CD4:CD8 ratios or increased CD7 loss on T cells, and they warrant additional diagnostic caution. Fine‐needle aspiration–based flow cytometry of lymph nodes is comparable to excisional biopsy and exhibits similar outliers. The reference ranges provided in this study can aid pathologists and contribute in the long term to computational flow analysis and biomedical research.
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Affiliation(s)
- Gregory D Scott
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Hubert D Lau
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Jason H Kurzer
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Christina S Kong
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Dita A Gratzinger
- Department of Pathology, Stanford University School of Medicine, Stanford, California
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Klippert A, Stolte-Leeb N, Neumann B, Sauermann U, Daskalaki M, Gawanbacht A, Kirchhoff F, Stahl-Hennig C. Frequencies of lymphoid T-follicular helper cells obtained longitudinally by lymph node fine-needle aspiration correlate significantly with viral load in SIV-infected rhesus monkeys. J Med Primatol 2015; 44:253-62. [PMID: 26227257 DOI: 10.1111/jmp.12186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND T-follicular helper (T(FH)) cells are an important population in lymph nodes (LNs) contributing to the generation of highly specific B cells. For SIV studies in rhesus macaques (RM), analysis of LN is necessary, but restricted due to invasive sampling. We applied the minimally invasive LN fine-needle aspiration (LN-FNA) and examined dynamics of T(FH) cells during SIV infection. MATERIALS AND METHODS LN-FNA and LN resection were carried out on uninfected RM. Lymphocytes were analyzed by flow cytometry. Additionally, cells obtained by LN-FNA over time from SIV-infected RM were analyzed. RESULTS Percentages of lymphocyte subsets were similar in LN aspirates and whole LNs. Analysis of LN aspirates from SIV-infected RM demonstrated a decrease of CD4(+) T cells, while T(FH) cell frequencies increased over time and correlated significantly with plasma viral load. CONCLUSIONS By applying LN-FNA, we showed that T(FH) cell expansion in chronic SIV infection is associated with viral load.
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Affiliation(s)
- Antonina Klippert
- Unit of Infection Models, German Primate Center, Goettingen, Germany
| | | | - Berit Neumann
- Unit of Infection Models, German Primate Center, Goettingen, Germany
| | - Ulrike Sauermann
- Unit of Infection Models, German Primate Center, Goettingen, Germany
| | - Maria Daskalaki
- Unit of Infection Models, German Primate Center, Goettingen, Germany
| | - Ali Gawanbacht
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Frank Kirchhoff
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
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Barrena S, Almeida J, Del Carmen García-Macias M, López A, Rasillo A, Sayagués JM, Rivas RA, Gutiérrez ML, Ciudad J, Flores T, Balanzategui A, Caballero MD, Orfao A. Flow cytometry immunophenotyping of fine-needle aspiration specimens: utility in the diagnosis and classification of non-Hodgkin lymphomas. Histopathology 2011; 58:906-18. [DOI: 10.1111/j.1365-2559.2011.03804.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Utility of Flow Cytometry Immunophenotyping in Fine-needle Aspirate Cytologic Diagnosis of Non-Hodgkin Lymphoma. Appl Immunohistochem Mol Morphol 2010; 18:311-22. [DOI: 10.1097/pai.0b013e3181827da8] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gautam U, Srinivasan R, Rajwanshi A, Bansal D, Marwaha RK. Comparative evaluation of flow-cytometric immunophenotyping and immunocytochemistry in the categorization of malignant small round cell tumors in fine-needle aspiration cytologic specimens. Cancer 2009; 114:494-503. [PMID: 19073016 DOI: 10.1002/cncr.23948] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The precise diagnosis of malignant small round cell tumors (MSRCTs) in fine-needle aspiration (FNA) cytology is a challenge that requires ancillary investigations. In this study, the authors evaluated the applicability of flow-cytometric immunophenotyping (FCI) and compared it with immunocytochemistry (ICC) for the accurate categorization of MSRCTs. METHODS In total, 37 consecutive MSRCTs that had been diagnosed with FNA cytology were analyzed by ICC and FCI using a panel of antibodies against desmin, vimentin, CD99/major histocompatibility class I-related antigen 2, neuron-specific enolase, and pancytokeratin. The final diagnoses included Ewing sarcoma (n = 17), rhabdomyosarcoma (n = 6; 4 embryonal and 2 alveolar subtypes), neuroblastoma (n = 10), desmoplastic small round cell tumor (n = 2), and retinoblastoma (n = 2). RESULTS Accurate categorization was possible in 67.5% of cases by ICC and in 64.8% of cases by FCI. Concordant immunophenotyping results with either technique were obtained in 21 cases (59.4%). Low cellularity of the sample and negativity for all markers tested were some limitations to both techniques when applied on fine-needle aspirates. However, using a combination of both techniques, 86.4% (32 of 37 cases) MSRCTs were typed accurately. CONCLUSIONS FCI is applicable on FNA material and complements ICC in accurate the typing of MSRCTs. This is particularly useful in advanced-stage disease, when neoadjuvant chemotherapy may be instituted promptly.
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Affiliation(s)
- Upasana Gautam
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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El-Sayed AM, El-Borai MH, Bahnassy AA, El-Gerzawi SMS. Flow cytometric immunophenotyping (FCI) of lymphoma: correlation with histopathology and immunohistochemistry. Diagn Pathol 2008; 3:43. [PMID: 18986555 PMCID: PMC2637251 DOI: 10.1186/1746-1596-3-43] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Accepted: 11/06/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the role of flow cytometric immunophenotyping (FCI) in diagnosis and characterization of lymphoma tissue specimens from Egyptian patients. METHODS FCI using 2 and 3 color staining approaches, was performed on 50 fresh lymph nodes specimen from Cairo NCI patients with suspected lymphoma presenting with either localized or generalized lymphadenopathy.FCI results were correlated with histopathologic as well as immunophenotypic[by immunohistochemistry (IHC)] findings. RESULTS By FCI, cases were diagnosed as follows: 9(18%) reactive hyperplasia (RH), 32(64%) B-cell non-Hodgkin's lymphoma (B-NHL) [24 diffuse large (DLBCL), 2 follicular, 3 small lymphocytic, 2 mantle cell lymphoma and a case of T cell rich B cell lymphoma], 3 (6%) T cell NHL [2 peripheral T cell lymphoma and a case of anaplastic large cell lymphoma], 2(4%) Hodgkin's lymphoma (HL) while 4 (8%) were non-lymphomatous tumors (NLT). Light chain restriction (LCR) was detected in the 32 FCI diagnosed B-NHL. The overall concordance between FCI versus histopathology and IHC was 88%. The sensitivity and specificity of FCI in diagnosis of NHL was 94.9% and 100% respectively; in HL they were 40% and 100% respectively and in NLT, both sensitivity and specificity were 100% while for RH were 100% and 89.1% respectively. CONCLUSION FCI is a sensitive and specific method in diagnosis and classification of NHL as well as in detection of monoclonality. False negative results could be due to the presence of heterogeneous populations of lymphocytes in special types of lymphoma.
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Affiliation(s)
- Abeer M El-Sayed
- Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
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Caraway NP. Strategies to diagnose lymphoproliferative disorders by fine-needle aspiration by using ancillary studies. Cancer 2005; 105:432-42. [PMID: 16222688 DOI: 10.1002/cncr.21452] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Nancy P Caraway
- Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
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