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Published on: December 6, 2014
Normative data for flow cytometry immunophenotyping of benign lymph nodes sampled by surgical biopsy
Gregory David Scott1, Susan K Atwater1, Dita A Gratzinger1
1Department of Pathology, Stanford Hospital and Clinics, Stanford, California, USA.
Insights
Flow cytometry data for benign lymph nodes establish normative ranges for clinical use. While outliers are common in benign cases, especially with immunosuppression, they do not predict lymphoma development.
Area of Science:
- Immunology
- Hematopathology
- Clinical Diagnostics
Background:
- Normative flow cytometry data for benign lymph nodes are limited.
- Accurate interpretation of lymph node immunophenotypes is crucial for diagnosing lymphoid malignancies.
Purpose of the Study:
- To establish clinically relevant normative flow cytometry data for benign lymph nodes.
- To characterize outliers in benign lymph node samples.
Main Methods:
- Collected and summarized clinical, histological, and flow cytometry data from 380 benign lymph node excisional biopsies.
- Analyzed outliers for kappa:lambda light chain ratio, CD10:CD19, CD5:CD19 coexpression, CD4:CD8 ratios, and CD7 loss.
Main Results:
- Generated the largest dataset of benign lymph node immunophenotypes to date.
- Identified that B and T cell antigen outliers were associated with background immunosuppression or inflammatory disease.
- Observed no subsequent lymphoma development in patients with these outliers.
Conclusions:
- Provided normative ranges for diagnostic immunophenotyping of benign lymph nodes.
- Found that 26% of benign lymph nodes exhibit outliers that may raise suspicion for lymphoma.
- Emphasized caution in interpreting outliers without excisional biopsy or clinical history, especially in immunosuppressed patients.
Aims:
To create clinically relevant normative flow cytometry data for understudied benign lymph nodes and characterise outliers.
Methods:
Clinical, histological and flow cytometry data were collected and distributions summarised for 380 benign lymph node excisional biopsies. Outliers for kappa:lambda light chain ratio, CD10:CD19 coexpression, CD5:CD19 coexpression, CD4:CD8 ratios and CD7 loss were summarised for histological pattern, concomitant diseases and follow-up course.
Results:
We generated the largest data set of benign lymph node immunophenotypes by an order of magnitude. B and T cell antigen outliers often had background immunosuppression or inflammatory disease but did not subsequently develop lymphoma.
Conclusions:
Diagnostic immunophenotyping data from benign lymph nodes provide normative ranges for clinical use. Outliers raising suspicion for B or T cell lymphoma are not infrequent (26% of benign lymph nodes). Caution is indicated when interpreting outliers in the absence of excisional biopsy or clinical history, particularly in patients with concomitant immunosuppression or inflammatory disease.
