Flow Cytometry in the Differential Diagnosis of CD10-Positive Nodal Lymphomas
Marc Sorigue1, Mireia Santos-Gomez1, Martina Comes1
1Department of Laboratory Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Spain.
Insights
Flow cytometry can distinguish follicular lymphoma (FL) from diffuse large B-cell lymphoma/high-grade B-cell lymphoma (DLBCL/HGBL). Two models effectively exclude DLBCL/HGBL, aiding in accurate lymphoma diagnosis.
Area of Science:
- Hematology
- Oncology
- Immunophenotyping
Background:
- Distinguishing follicular lymphoma (FL) from diffuse large B-cell lymphoma/high-grade B-cell lymphoma (DLBCL/HGBL) using flow cytometry is challenging.
- Previous studies have underexplored flow cytometry's utility in differentiating these B-cell lymphomas.
Purpose of the Study:
- To evaluate flow cytometry parameters for differentiating FL from DLBCL/HGBL.
- To develop models for reliably excluding DLBCL/HGBL in lymph node biopsies.
Main Methods:
- Retrospective analysis of flow cytometry data from 191 lymph node biopsies diagnosed with FL or DLBCL/HGBL.
- Assessment of parameters including forward scatter (FS), side scatter (SS), and %CD23.
- Development and testing of predictive models for DLBCL/HGBL exclusion.
Main Results:
- Forward scatter, side scatter, and %CD23 were significant differentiating parameters between FL and DLBCL/HGBL.
- Two developed models demonstrated high sensitivity (>0.90) and negative predictive values (≥0.95) for excluding DLBCL/HGBL.
- Light scatter characteristics alone could not reliably distinguish grade 3 FL from DLBCL/HGBL.
Conclusions:
- Simple flow cytometry-based models can confidently exclude DLBCL/HGBL.
- These models can aid in the accurate diagnosis and classification of B-cell lymphomas.
Background:
Differences between follicular lymphoma (FL) and diffuse large B-cell lymphoma/high-grade B-cell lymphoma (DLBCL/HGBL) by flow cytometry are underexplored.
Methods:
We retrospectively assessed flow cytometry results from 191 consecutive lymph node biopsies diagnosed with FL or DLBCL/HGBL.
Results:
The only parameters that differed between the 2 groups in the derivation cohort were forward scatter and side scatter (P < 10-6; area under the curve [AUC], 0.75-0.8) and %CD23 (P = .004; area under the receiver characteristic operating curve, 0.64). However, since light scatter characteristics did not distinguish between grade 3 FL and DLBCL/HGBL, we set out to develop a model with high sensitivity for the exclusion of the latter. Several models, including FS and %CD23, were tested, and 2 models showed a sensitivity of >0.90, with negative predictive values of ≥0.95, albeit with low specificity (0.45 to 0.57).
Conclusion:
Two simple models enable the exclusion of DLBCL/HGBL with a high degree of confidence.
