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Published on: December 6, 2014
Combined cytomorphologic and immunophenotypic approach to evaluation of effusions for lymphomatous involvement
1Department of Pathology, St. Louis University Health Sciences Center, MO 63104, USA.
Insights
Flow cytometry combined with cytomorphology reliably detects lymphoma in effusions. This method is recommended for diagnosing non-Hodgkin
Area of Science:
- Hematology
- Oncology
- Cytopathology
Background:
- Malignant effusions can be challenging to diagnose.
- Accurate diagnosis is crucial for effective non-Hodgkin's lymphoma (NHL) treatment.
Purpose of the Study:
- To evaluate the reliability of combining cytomorphology and immunophenotypic analysis for detecting lymphomatous involvement in effusion specimens.
- To assess the utility of flow cytometric immunophenotyping in diagnosing NHL in effusions.
Main Methods:
- Thirty effusion specimens from patients with suspected or diagnosed NHL were analyzed.
- Cytomorphological evaluation was performed on all specimens.
- Flow cytometric immunophenotyping using a broad panel of monoclonal antibodies was applied.
Main Results:
- Fifty percent of previously diagnosed NHL patients showed lymphomatous involvement in effusions.
- Sixty-nine percent of positive effusions represented newly diagnosed NHL.
- Tissue biopsy was obviated in 36% of newly diagnosed cases due to high-grade or small lymphocytic lymphoma cell types.
Conclusions:
- Combining cytomorphology and flow cytometry is a reliable, non-invasive, and rapid method for diagnosing lymphoma in effusions.
- Flow cytometry is recommended for effusion evaluation in NHL, offering significant therapeutic implications.
- This approach can expedite diagnosis and potentially avoid invasive procedures like tissue biopsy.
Abstract:
Combining cytomorphology and immunophenotypic data in evaluation of effusions for lymphomatous involvement is reliable, non-invasive, and expeditious. In this study, 30 effusion specimens from 30 patients with clinically suspected or previously diagnosed non-Hodgkin's lymphoma (NHL) were evaluated cytomorphologically and by flow cytometric immunophenotyping with a large panel of monoclonal antibodies. Of 11 patients with a previous diagnosis of NHL, 50% had cytomorphologic and immunophenotypic evidence of lymphomatous involvement of effusion specimens; therefore, flow cytometric immunophenotyping is recommended in these cases since there may be substantial therapeutic impact. In addition, 69% of the effusions positive for lymphomatous involvement represented newly diagnosed NHL; in 36% of these cases, tissue biopsy was not necessary since they were either high-grade (lymphoblastic or small, non-cleaved cell type) or of the small lymphocytic lymphoma cell type.
