SIGNIFICANT ROLE OF FLOW CYTOMETRY IN THE DIAGNOSIS AND FOLLOW UP OF GASTRIC LNH
(Abstract release date: 05/19/16)
EHA Library. Luponio S. 06/09/16; 134779; PB1879
Dr. Serena Luponio
Contributions
Contributions
Abstract
Abstract: PB1879
Type: Publication Only
Background
The diagnosis of lymphoma is mainly based on morphology, but the diagnostic accuracy is greatly increased by the use of ancillary techniques like immunophenotyping, cytogenetic and molecular tests. This multiparametric approach is recommended by WHO classification.
Aims
To evaluate the role of flow cytometry in the study of gastric biopsies with suspect of NHL. We have assessed the validity of integration of histological and cytometric assays to optimize diagnosis of lymphoproliferative diseases and to lower the number of inconclusive cases at histological exam. The aim of flow cytometry was to define lineage and clonality of lymphoid proliferation, thus giving a support to final diagnostic assessment.
Methods
33 patients with primary gastric lymphoma underwent, from January 2007 to December 2015, to double gastric biopsy at diagnosis or during follow up. Diagnosis was MALT in 19/33 (58%), DLBCL in 9/33 (27%) and other histological type in 5/33 (15%). Every patient underwent complete staging and the stage was I/E in 18/33 and II/E in 15/33. Therapy was antibiotic eradication of HP in 8/33 pz and chemo-immunotherapy in accordance with guidelines. Samples for histology were fixed with formalin and stained with HE, then tested by antibodies for CD3, CD5, CD10, CD20, CD21, CD23, CD30, CD38, CD43, CD45RO, CD79a, CiclinaD1, BCL-2, BCL-6, Ki67, EMA, k e l. Samples for flow cytometry were put in saline, sent to laboratory within thirty minutes and processed with standard methods. A cytometric pattern was defined as pathological if there was an evident atypical assembly of B or T lymphoid antigens along with clonal restriction for Ig light chains or TCRVb repertoire.
Results
We have carried out 44 biopsies in a population of 33 patients and we obtained a final diagnosis in all cases. Diagnosis was: NHL in 11/42 (9 MALT,1 follicular lymphoma,1 DLBCL), plasmacytoma in 1/42, and benign conditions in the remaining 32/44. There was strict concordance between the two methods, but in one case flow cytometry was negative and histology was positive for lymphoma, in other one positivity of flow cytometry led to histological revision and, finally, to full concordance.
Conclusion
This study demonstrated that flow cytometry is an easy and reliable diagnostic tool for gastric lymphoma: assumed that its goal is to assess lineage and clonality, it is fast, sensitive and specific. It is synergistic to histology, especially in difficult cases like biopsy performed during a revaluation after chemotherapy or antibiotic therapy, or reactive conditions where lymphoid infiltrates can mimic lymphoma. Histological diagnosis certainly remains the gold standard for lymphoma diagnosis but flow cytometric typing can usefully support histology to reach a correct diagnosis in 100% of cases.
Session topic: E-poster
Keyword(s): Flow cytometry, Gastric MALT lymphoma, Lymphoma
Type: Publication Only
Background
The diagnosis of lymphoma is mainly based on morphology, but the diagnostic accuracy is greatly increased by the use of ancillary techniques like immunophenotyping, cytogenetic and molecular tests. This multiparametric approach is recommended by WHO classification.
Aims
To evaluate the role of flow cytometry in the study of gastric biopsies with suspect of NHL. We have assessed the validity of integration of histological and cytometric assays to optimize diagnosis of lymphoproliferative diseases and to lower the number of inconclusive cases at histological exam. The aim of flow cytometry was to define lineage and clonality of lymphoid proliferation, thus giving a support to final diagnostic assessment.
Methods
33 patients with primary gastric lymphoma underwent, from January 2007 to December 2015, to double gastric biopsy at diagnosis or during follow up. Diagnosis was MALT in 19/33 (58%), DLBCL in 9/33 (27%) and other histological type in 5/33 (15%). Every patient underwent complete staging and the stage was I/E in 18/33 and II/E in 15/33. Therapy was antibiotic eradication of HP in 8/33 pz and chemo-immunotherapy in accordance with guidelines. Samples for histology were fixed with formalin and stained with HE, then tested by antibodies for CD3, CD5, CD10, CD20, CD21, CD23, CD30, CD38, CD43, CD45RO, CD79a, CiclinaD1, BCL-2, BCL-6, Ki67, EMA, k e l. Samples for flow cytometry were put in saline, sent to laboratory within thirty minutes and processed with standard methods. A cytometric pattern was defined as pathological if there was an evident atypical assembly of B or T lymphoid antigens along with clonal restriction for Ig light chains or TCRVb repertoire.
Results
We have carried out 44 biopsies in a population of 33 patients and we obtained a final diagnosis in all cases. Diagnosis was: NHL in 11/42 (9 MALT,1 follicular lymphoma,1 DLBCL), plasmacytoma in 1/42, and benign conditions in the remaining 32/44. There was strict concordance between the two methods, but in one case flow cytometry was negative and histology was positive for lymphoma, in other one positivity of flow cytometry led to histological revision and, finally, to full concordance.
Conclusion
This study demonstrated that flow cytometry is an easy and reliable diagnostic tool for gastric lymphoma: assumed that its goal is to assess lineage and clonality, it is fast, sensitive and specific. It is synergistic to histology, especially in difficult cases like biopsy performed during a revaluation after chemotherapy or antibiotic therapy, or reactive conditions where lymphoid infiltrates can mimic lymphoma. Histological diagnosis certainly remains the gold standard for lymphoma diagnosis but flow cytometric typing can usefully support histology to reach a correct diagnosis in 100% of cases.
Session topic: E-poster
Keyword(s): Flow cytometry, Gastric MALT lymphoma, Lymphoma
Abstract: PB1879
Type: Publication Only
Background
The diagnosis of lymphoma is mainly based on morphology, but the diagnostic accuracy is greatly increased by the use of ancillary techniques like immunophenotyping, cytogenetic and molecular tests. This multiparametric approach is recommended by WHO classification.
Aims
To evaluate the role of flow cytometry in the study of gastric biopsies with suspect of NHL. We have assessed the validity of integration of histological and cytometric assays to optimize diagnosis of lymphoproliferative diseases and to lower the number of inconclusive cases at histological exam. The aim of flow cytometry was to define lineage and clonality of lymphoid proliferation, thus giving a support to final diagnostic assessment.
Methods
33 patients with primary gastric lymphoma underwent, from January 2007 to December 2015, to double gastric biopsy at diagnosis or during follow up. Diagnosis was MALT in 19/33 (58%), DLBCL in 9/33 (27%) and other histological type in 5/33 (15%). Every patient underwent complete staging and the stage was I/E in 18/33 and II/E in 15/33. Therapy was antibiotic eradication of HP in 8/33 pz and chemo-immunotherapy in accordance with guidelines. Samples for histology were fixed with formalin and stained with HE, then tested by antibodies for CD3, CD5, CD10, CD20, CD21, CD23, CD30, CD38, CD43, CD45RO, CD79a, CiclinaD1, BCL-2, BCL-6, Ki67, EMA, k e l. Samples for flow cytometry were put in saline, sent to laboratory within thirty minutes and processed with standard methods. A cytometric pattern was defined as pathological if there was an evident atypical assembly of B or T lymphoid antigens along with clonal restriction for Ig light chains or TCRVb repertoire.
Results
We have carried out 44 biopsies in a population of 33 patients and we obtained a final diagnosis in all cases. Diagnosis was: NHL in 11/42 (9 MALT,1 follicular lymphoma,1 DLBCL), plasmacytoma in 1/42, and benign conditions in the remaining 32/44. There was strict concordance between the two methods, but in one case flow cytometry was negative and histology was positive for lymphoma, in other one positivity of flow cytometry led to histological revision and, finally, to full concordance.
Conclusion
This study demonstrated that flow cytometry is an easy and reliable diagnostic tool for gastric lymphoma: assumed that its goal is to assess lineage and clonality, it is fast, sensitive and specific. It is synergistic to histology, especially in difficult cases like biopsy performed during a revaluation after chemotherapy or antibiotic therapy, or reactive conditions where lymphoid infiltrates can mimic lymphoma. Histological diagnosis certainly remains the gold standard for lymphoma diagnosis but flow cytometric typing can usefully support histology to reach a correct diagnosis in 100% of cases.
Session topic: E-poster
Keyword(s): Flow cytometry, Gastric MALT lymphoma, Lymphoma
Type: Publication Only
Background
The diagnosis of lymphoma is mainly based on morphology, but the diagnostic accuracy is greatly increased by the use of ancillary techniques like immunophenotyping, cytogenetic and molecular tests. This multiparametric approach is recommended by WHO classification.
Aims
To evaluate the role of flow cytometry in the study of gastric biopsies with suspect of NHL. We have assessed the validity of integration of histological and cytometric assays to optimize diagnosis of lymphoproliferative diseases and to lower the number of inconclusive cases at histological exam. The aim of flow cytometry was to define lineage and clonality of lymphoid proliferation, thus giving a support to final diagnostic assessment.
Methods
33 patients with primary gastric lymphoma underwent, from January 2007 to December 2015, to double gastric biopsy at diagnosis or during follow up. Diagnosis was MALT in 19/33 (58%), DLBCL in 9/33 (27%) and other histological type in 5/33 (15%). Every patient underwent complete staging and the stage was I/E in 18/33 and II/E in 15/33. Therapy was antibiotic eradication of HP in 8/33 pz and chemo-immunotherapy in accordance with guidelines. Samples for histology were fixed with formalin and stained with HE, then tested by antibodies for CD3, CD5, CD10, CD20, CD21, CD23, CD30, CD38, CD43, CD45RO, CD79a, CiclinaD1, BCL-2, BCL-6, Ki67, EMA, k e l. Samples for flow cytometry were put in saline, sent to laboratory within thirty minutes and processed with standard methods. A cytometric pattern was defined as pathological if there was an evident atypical assembly of B or T lymphoid antigens along with clonal restriction for Ig light chains or TCRVb repertoire.
Results
We have carried out 44 biopsies in a population of 33 patients and we obtained a final diagnosis in all cases. Diagnosis was: NHL in 11/42 (9 MALT,1 follicular lymphoma,1 DLBCL), plasmacytoma in 1/42, and benign conditions in the remaining 32/44. There was strict concordance between the two methods, but in one case flow cytometry was negative and histology was positive for lymphoma, in other one positivity of flow cytometry led to histological revision and, finally, to full concordance.
Conclusion
This study demonstrated that flow cytometry is an easy and reliable diagnostic tool for gastric lymphoma: assumed that its goal is to assess lineage and clonality, it is fast, sensitive and specific. It is synergistic to histology, especially in difficult cases like biopsy performed during a revaluation after chemotherapy or antibiotic therapy, or reactive conditions where lymphoid infiltrates can mimic lymphoma. Histological diagnosis certainly remains the gold standard for lymphoma diagnosis but flow cytometric typing can usefully support histology to reach a correct diagnosis in 100% of cases.
Session topic: E-poster
Keyword(s): Flow cytometry, Gastric MALT lymphoma, Lymphoma
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