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Published on: November 10, 2023
Discrepant immunophenotypic characteristics between the lymph node and bone marrow in two mixed-phenotype acute
Min Jung Song1, Hee Jin Kim, Young Hyeh Ko
1Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Insights
In acute leukemia, immunophenotypic analysis of bone marrow and lymph node biopsies may show discrepancies. This highlights the need to integrate all diagnostic data for accurate leukemia diagnosis and treatment.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Immunophenotypic profiling is crucial for diagnosing hematological malignancies, typically showing consistency across different anatomical sites.
- Acute leukemia diagnosis commonly relies on consistent immunophenotypes in peripheral blood, bone marrow, or lymph nodes.
Observation:
- This study reports two Korean patients with acute leukemia exhibiting discordant immunophenotypes between bone marrow specimens and cervical lymph node biopsies.
- Specific discrepancies were noted in myeloperoxidase (MPO) and CD3 expression.
Findings:
- Immunophenotypic analysis revealed differing results between bone marrow and lymph node biopsies in these acute leukemia cases.
- Discordant immunophenotypes, though rare, can occur in a subset of leukemia patients involving multiple anatomical sites.
Implications:
- The clinical significance of this immunophenotypic disparity in acute leukemia remains to be determined.
- Integrating findings from various diagnostic sources, including bone marrow and biopsy studies, is essential for accurate diagnosis and treatment planning in leukemia.
- Recognizing potential immunophenotypic discrepancies is vital for optimizing patient management in hematological malignancies.
Abstract:
The immunophenotypic profile of hematological malignancies is usually consistent among different sites of involvement; this consistency allows reliable diagnosis from peripheral blood, bone marrow, or lymph node, especially in cases of acute leukemia. Although in a minority of lymphoma patients, two or more different populations with discordant immunophenotypes have been described, either at the same or distinct sites. Here, we report two Korean patients with acute leukemia where the results of immunophenotypic analysis of the bone marrow specimen were different from those of immunohistochemical studies of a biopsy sample of a cervical lymph node, particularly with respect to myeloperoxidase and CD3. The clinical significance of the immunophenotypic disparity found in the patients still remains unknown; however, discrepancies between the different anatomic sites that are simultaneously involved can occur in a subset of leukemia patients. Therefore, integration of all the relevant results, including those of the bone marrow studies, may be helpful for accurate diagnosis and selecting appropriate treatment modalities.
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