SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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M.M. KARDUM PARO1 , Z. ŠIFTAR1 , A. NAZOR1 , Z. FLEGAR - MEŠTRIĆ1 , I. KARDUM - SKELIN2 , D. ŠUŠTERČIĆ2 , B. JAKŠIĆ2

1INSTITUTE OF CLINICAL CHEMISTRY UNIVERSITY HOSPITAL "MERKUR", ZAGREB, CROATIA, 2DEPARTMENT OF INTERNAL MEDICINE UNIVERSITY HOSPITAL "MERKUR", ZAGREB, CROATIA

Objective. A large retrospective analysis of the flow cytometric immunophenotyping (FCI) in the less frequently used tissue biopsies (fine-needle aspirate, FNA) with suspected lymphoma together with specific and sensitive identification of the malignant cells represents the purpose of this study. Patients and methods. In a series of 423 patients with lymphadenopathy, during three years 423 FNA samples coupled with FCI were studied. Hematopoietic cells were labeled with a selection of fluorescent antibodies and quantified, according to their cell surface antigens, using a multiparameter flow cytometer Coulter EPICS XL. The particular pattern of abnormal antigen expression was used to identify a malignant clone. FCI results were quantified with Coulter EPICS XL System II software and comparison with cytologic results was done. Results. FNA biopsy yielded adequate cells for analysis, only in 18.6% (92) cases insufficient cels were collected. Overall, malignancy was diagnosed in 258 cases (67.6%) from total of 327, 69 cases (18.3%) were correctly diagnosed as reactive process. Obtained diagnostic concordance between FCI and cytomorphology in the group of reactive hyperplasia was 93.2%, and in the group of B-NHL 94.8%. According The Working Classification of Lymphomas subclassification of B-NHLs into two groups (low-grade and high-grade NHLs) yielded further diagnostic concordance between methods: 93.6% (B-CLL), 88.2% (B-NHL /FC) and 86.1% (large cells lymphoma). Summary and conclusion. FCI of FNA permits the separation between reactive processes and lymphoid malignancies in the majority of cases, beeing particulary useful in the identification of low malignant NHL with best accuracy achieved. The detection of high grade NHL by flow cytometry immunophenotyping was difficult. The same instrument settings used for routine FCI could be used for this type of analysis, but for an objective results evaluation concentration of at least 0.5 x 106 cells /mL is needed.

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