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Immunophenotypic analysis of non-Hodgkin's lymphomas in cytologic specimens: a correlative study of
A Simsir1, P Fetsch, M Stetler-Stevenson
1Laboratory of Pathology, National Institutes of Health/National Cancer Institute, Bethesda, Maryland 20892, USA.
Insights
Immunocytochemistry (IC) and flow cytometry (FC) are effective for diagnosing Non-Hodgkin's lymphoma (NHL) in cytology specimens. Both methods show high correlation, offering complementary strengths for accurate lymphoma classification.
Area of Science:
- Hematopathology
- Cytopathology
- Immunology
Background:
- Non-Hodgkin's lymphoma (NHL) diagnosis relies on morphology and immunophenotyping of cytology specimens.
- Immunophenotyping is crucial for classifying NHL and can be performed using immunocytochemistry (IC) or flow cytometry (FC).
Purpose of the Study:
- To compare the efficacy and correlation of immunocytochemistry (IC) and flow cytometry (FC) for diagnosing Non-Hodgkin's lymphoma (NHL) in cytology specimens.
- To evaluate the advantages and limitations of IC and FC in the immunophenotypic analysis of NHL.
Main Methods:
- Retrospective review of 98 cytology specimens (70 fine-needle aspirates, 28 effusions) from January 1992 to December 1997.
- Immunophenotyping performed using both IC and FC on the collected specimens.
- Analysis of discrepancies and specimen adequacy for each technique.
Main Results:
- High correlation (98%) between IC and FC when both techniques were applied to 85% of cases.
- FC was inadequate for 11% of cases, while IC was inadequate for 4%, highlighting differential specimen requirements.
- IC preserves cytomorphology, beneficial for necrotic samples; FC excels at detecting small monoclonal populations and offers objective parameters.
Conclusions:
- Both IC and FC are highly effective and largely interchangeable methods for immunophenotyping cytology specimens in NHL diagnosis.
- The choice between IC and FC may depend on institutional expertise, available resources, and specific case characteristics, such as specimen cellularity and tumor necrosis.
Abstract:
Most Non-Hodgkin's lymphomas(NHL) can be accurately diagnosed and classified based on morphologic and immunophenotypic findings on cytologic specimens. Immunophenotyping can be accomplished via immunocytochemistry (IC) or flow cytometry (FC). We reviewed our experience with 98 cytology specimens (70 fine-needle aspirates [FNA] and 28 effusions) that were submitted for immunophenotyping utilizing both IC and FC between January 1992 and December 1997 for the diagnosis of NHL. Eighty-five percent of the cases were immunophenotyped by both techniques. Among these there were only two discrepancies between IC and FC, yielding a 98% correlation rate. Of the 98 cases, 11% could not be immunophenotyped by FC and 4% could not be immunophenotyped by IC. The advantage of IC is the preservation of cytomorphology, which results in the requirement for a lower number of neoplastic cells and a limited, targeted panel of antibodies. This is especially useful in predominantly necrotic lymphomas in which only a few well-preserved neoplastic cells may be present, rendering the specimen inadequate for immunophenotyping by FC. The advantages of FC are in the detection of a small population of monoclonal cells in a background of reactive cells (particularly useful in effusion samples in which the predominant cell population is often reactive T lymphocytes), increased diagnostic precision through evaluation of objective parameters, and the use of multiple markers with dual labelling. We conclude that IC and FC are both excellent methods for immunophenotyping of cytology specimens and can be used interchangeably depending on the institutional expertise and availability.
