Flow cytometry and cytomorphology evaluation of hematologic malignancy in cerebrospinal fluids: comparison with retrospective clinical outcome

An independent clinical assessment was compared with flow cytometry (FCM) and cytomorphology results obtained on 227 cerebrospinal fluids investigated for hematologic malignancy, in a retrospective longitudinal study with a median observation time of 11 months. A combined method assessment (CMA), defining "positive" a sample if at least one method gave "positive" results, was also tested. Eleven out of 55 screening samples and 53 out of 166 follow-up samples resulted positive at clinical evaluation. FCM and CM were concordant with positive clinical assessment in 68.5% and 51.5% of cases, respectively. According to CMA, 10.5% of samples (resulting false negative by either FCM or cytomorphology) were rescued as true positive. FCM retained significantly higher accuracy than cytomorphology (p=0.0065) and 100% sensitivity when at least 220 leukocytes were acquired. CMA accuracy was higher than FCM accuracy and significantly higher than cytomorphology accuracy in the analysis of all samples (p<0.0001), samples from mature B/T cell neoplasms (p=0.0021), and samples drawn after intrathecal treatment (p=0.0001). When acquiring ≤220 leukocytes, FCM accuracy was poor, and combining cytomorphology added statistically significant diagnostic advantage (p=0.0043). Although FCM is the best diagnostic tool for evaluating CSF, morphology seems helpful especially when clinically positive follow-up samples are nearly acellular.

The Legnano radiology picture archiving and communication system/radiology information system project implementation

The necessity to meet the ever-increasing diagnostic and interventional demands in the most cost-effective and efficient way led to the decision to turn the Department of Radiology at Legnano City Hospital nearly filmless. Crucial for the implementation of this challenging project was the development of a sophisticated and efficient digital architecture along with a nearly global renovation of the whole department, connecting it in the meantime to the hospital asynchronous transfer mode (ATM) backbone. The highlights and drawbacks faced in the implementation of the project are described and discussed.

[Transitory bisalbuminemia secondary to pancreatitis with ascitic effusion]

A case of transient bisalbuminemia secondary to pancreatitis with ascites is described. The bisalbumin was of the "fast" type and disappeared after sixty days of therapy. The clinical and pathological implications of these findings are discussed.