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Detection of B-cell populations with monotypic light chain expression in cerebrospinal fluid specimens from patients

Poopak Vafaii1, Joseph A DiGiuseppe

  • 1Department of Pathology & Laboratory Medicine, Hartford Hospital, Hartford, Connecticut.

Cytometry. Part B, Clinical Cytometry
|July 3, 2013
PubMed

Insights

Monotypic B-cell populations in cerebrospinal fluid (CSF) detected by flow cytometry are not definitive for lymphoma. These findings may be common in multiple sclerosis, emphasizing the need for clinical correlation.

Area of Science:

  • Neurology
  • Immunology
  • Hematology

Background:

  • Flow cytometric immunophenotyping is used to detect leptomeningeal disease in aggressive B-cell non-Hodgkin lymphoma.
  • Its use is expanding for patients with neurological symptoms but no confirmed lymphoma diagnosis.
  • The specificity of flow cytometry for identifying monoclonal B-cells in CSF requires evaluation.

Purpose of the Study:

  • To systematically evaluate the specificity of flow cytometric immunophenotyping for identifying monoclonal B-cell populations in cerebrospinal fluid (CSF).
  • To determine if monotypic B-cell populations in CSF are indicative of B-cell non-Hodgkin lymphoma.

Main Methods:

  • A retrospective analysis of 8-color flow cytometric immunophenotyping on CSF specimens was performed.
  • The study focused on cases with detected monotypic B-cell populations in patients without clinical or radiographic evidence of lymphoma.
  • Specimens were collected between June 2010 and December 2012.

Main Results:

  • Monotypic B-cell populations were identified in CSF from three patients with no subsequent evidence of lymphoma.
  • All three patients were ultimately diagnosed with multiple sclerosis.
  • This indicates that monotypic B-cells in CSF are not exclusive to lymphoma.

Conclusions:

  • Detection of monotypic B-cell populations in CSF via polychromatic flow cytometry is not diagnostic of occult leptomeningeal lymphoma.
  • Monotypic B-cell populations detected by flow cytometry may be prevalent in patients with multiple sclerosis.
  • Clinicopathologic correlation is crucial for interpreting polychromatic flow cytometry findings in CSF.
Abstract

Keywords:
B cellscerebrospinal fluidflow cytometrymonoclonalmultiple sclerosispolychromatic

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