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Published on: October 9, 2018
Routine use of immunophenotype by flow cytometry in tissues with suspected hematological malignancies
Antoni Martínez1, Marta Aymerich, Mireia Castillo
1Hematopathology Unit, Department of Pathology, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Insights
Flow cytometry (FCM) aids in diagnosing hematological malignancies from tissue biopsies, offering rapid and reliable results. This method effectively identifies rare cancers and clonality in B-cell lymphomas, improving diagnostic accuracy.
Area of Science:
- Hematopathology
- Immunophenotyping
- Diagnostic Cytometry
Background:
- Immunophenotype is crucial for diagnosing hematological malignancies.
- Flow cytometry (FCM) is typically used for blood samples, not tissue biopsies.
- This study investigates FCM's utility in diagnosing hematological disorders from tissue biopsies.
Purpose of the Study:
- To evaluate the role and effectiveness of flow cytometry (FCM) in diagnosing hematological disorders from tissue biopsies.
- To compare FCM with standard morphology and immunohistochemistry (IHC) for biopsy analysis.
Main Methods:
- Analyzed 422 consecutive tissue biopsies using morphology, immunohistochemistry (IHC), and FCM.
- FCM results were obtained within 3 hours and interpreted independently.
- Compared FCM findings with morphology and IHC results.
Main Results:
- FCM showed a strong correlation with malignant disease (218/250 cases), except for Hodgkin disease.
- FCM demonstrated high positive predictive value (1) and identified light chain restriction in B-cell lymphomas (182/201).
- FCM enabled rapid diagnosis of rare malignancies and detection of double pathologies.
Conclusions:
- FCM is a fast, reliable method for phenotyping tissue samples in diagnosing hematological malignancies.
- FCM excels at detecting infrequent cancers, specific phenotypes, and clonality in B-cell lymphomas.
- FCM aids in diagnosing composite or double pathologies by recognizing multiple cell populations simultaneously.
Background:
Immunophenotype is an essential parameter in the diagnosis of hematological malignancies. Flow cytometry (FCM) is used in the analysis of bone marrow or peripheral blood samples but is less frequently used in the evaluation of tissue biopsies with suspected hematological malignancies. The aim of this study was to analyze the role of FCM in the diagnosis of biopsies from patients with a suspected hematological disorder.
Methods:
A total of 422 consecutive biopsies were studied using standard morphology, immunohistochemistry (IHC), and FCM. Results of FCM were obtained in less than 3 h and were interpreted independently from morphology and IHC.
Results:
A strong correlation between malignant disease and abnormal pattern of FCM was observed (218 of 250) with the exception of Hodgkin disease (P < 0.001). Overall, negative predictive value was 0.52 and positive predictive value was 1. Light chain restriction was observed in 182 of 201 B-cell lymphoma and in 0 of 142 non-B-cell disorders by FCM. In contrast, light chain pattern could only be evaluated in 38 of 91 cases by IHC. FCM allowed a rapid diagnosis of infrequent or high-grade malignancies such as histiocytic sarcoma or T-lymphoblastic lymphoma. The addition of FCM in the routine study of tissue biopsies facilitates the diagnosis of double pathology in five (1%) patients.
Conclusions:
FCM is a fast and reliable methodology for phenotyping tissue samples, which easily detects infrequent hematological malignancies, disease-specific phenotypes and clonality in B-cell lymphomas. Moreover, the simultaneous recognition of different cell populations allows the diagnosis of composite cell lymphomas, or double pathologies.
