Rapid detection of neoplastic cells in serous cavity effusions in children with flow cytometry immunophenotyping

The aim of the study was to evaluate the role of flow cytometric immunophenotyping (FCI) as a rapid diagnostic tool for pediatric malignancy in serous cavity effusions (SCEs). FCI results for 103 SCEs in a pediatric population were compared with retrospective clinical outcomes (RCOs). Among 41 patients assessed as having malignancies by RCO, 36 patients were diagnosed with lymphoma (n =25), acute myeloid leukemia (n =2), neuroblastoma (n =8) and retinoblastoma (n =1) by FCI, respectively. The sensitivity and specificity of FCI for detecting neoplastic cells were 87.8% and 98.4%, respectively. The concordance of FCI data with final diagnoses of the patients was 94.2%. FCI data for lymphoma was concordant with the final diagnosis in 89.3% of cases. When Hodgkin lymphoma was excluded, the overall correlation increased to 96.1%. FCI is a useful tool for rapid and reliable diagnosis of pediatric non-Hodgkin lymphoma in SCE samples and also to suggest the presence of non-lymphoid malignancies, especially neuroblastoma.