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Flow Cytometric Analysis of Mediastinal Masses in Cats: A Retrospective Study
Serena Bernardi1,2, Valeria Martini1,2, Stefano Perfetto3
1Department of Veterinary Medicine, University of Milan, Lodi, Italy.
Insights
Flow cytometry (FC) can help diagnose feline mediastinal masses, but differentiating lymphoma from other lesions is challenging. The high prevalence of CD4+CD8+ T-cells in feline lymphomas makes FC alone insufficient for diagnosis.
Area of Science:
- Veterinary Medicine
- Immunology
- Oncology
Background:
- Mediastinal masses in cats, including thymoma and lymphoma, pose diagnostic challenges.
- Cytology alone may not reliably distinguish between these conditions, particularly with small/medium lymphocytes.
Purpose of the Study:
- To characterize the flow cytometry (FC) features of feline mediastinal masses.
- To evaluate FC's effectiveness in differentiating feline lymphoma from non-lymphomatous lesions.
Main Methods:
- Retrospective analysis of fine needle aspiration cytology from cats with mediastinal masses.
- Flow cytometry was used to assess scatter properties and cell surface markers (CD5, CD4, CD8, CD21, CD18) and their co-expressions.
- Cases were classified as lymphoma or non-lymphoma based on cytology, histopathology, PARR, clinical data, and follow-up.
Main Results:
- The study included 20 cats (12 lymphoma, 8 non-lymphoma).
- Lymphoid cells in the lymphoma group exhibited higher forward scatter (FSC).
- CD4+CD8+ double-positive T-cells predominated in 8/12 lymphomas, while non-lymphomatous lesions lacked a dominant lymphoid population in 5/8 cases.
Conclusions:
- Flow cytometry alone has limitations in differentiating feline lymphoma from non-lymphomatous mediastinal masses due to a high prevalence of CD4+CD8+ T-cell lymphomas.
- FC can provide valuable diagnostic information, but PCR for antigen receptor rearrangement (PARR) and histopathology are essential for definitive diagnosis, especially with ambiguous lymphoid cell populations.
Abstract:
Mediastinal masses occur in dogs and cats and are often investigated with cytology. However, discrimination between the two most common lesions (thymoma and lymphoma) may be challenging, especially when small/medium lymphocytes represent the prevalent population. The aim of the present study is to describe the flow cytometric aspects of mediastinal masses in cats and to assess the ability of flow cytometry (FC) to differentiate lymphoma from non-lymphomatous lesions. We retrospectively describe FC features of fine needle aspiration cytology from cats with mediastinal masses. Cases were grouped in lymphoma and non-lymphoma based on results of cytology, histopathology, PCR for antigen receptor rearrangement (PARR), clinical presentation, and follow-up. Scatter properties, positivities to CD5, CD4, CD8, CD21, CD18, and their co-expressions were recorded using a multicolour approach. Twenty cats were included, 12 lymphomas and eight non-lymphomatous cases. Forward scatter (FSC) of lymphoid cells was higher in the lymphoma group. Double positive CD4+CD8+ T-cells were the dominant population in eight out of 12 lymphomas, whereas non-lymphomatous lesions showed no dominant lymphoid population in five out of eight cases. Unlike dogs, the high prevalence of CD4+CD8+ lymphomas in cats it makes difficult to differentiate lymphoma from non-lymphomatous lesions using FC alone. FC may add interesting information to refine diagnosis in some cases, but PARR and histopathology remain mandatory to solve differential in case of expansion of small-medium sized double positive lymphoid cells.
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