Flow cytometry in the diagnosis of mature B‐cell lymphoproliferative disorders

Abstract

B-lineage lymphoproliferative disorders (LPD) are rather frequent diseases, associated with specific clinical or biological features but also sometimes of fortuitous discovery. Multiparameter flow cytometry plays a major role for a rapid diagnostic indication, on peripheral blood or bone marrow samples in most instances, guiding complementary analyses and allowing for the proper therapeutic management of patients. After describing the important pre-analytical precautions required for an adequate assessment, the immunophenotypic features of small-cell and large-cell lymphomas are described in this review. The ubiquitous expression of CD19 is a first mandatory gating step. A possible clonal proliferation is then suspected by the demonstration of surface immunoglobulin light chain restriction. The aberrant presence of CD5 allows to segregate chronic lymphocytic leukemia and mantle cell lymphoma in most cases. Other LPD exhibit specific immunophenotypic features. A table of useful markers and a decision tree are provided. Of note, immunophenotypic data should as much as possible be interpreted in an integrated manner, involving the patient's clinical and other biological features, and be completed by further chromosomal and/or molecular investigations. K E Y W O R D S B-cell lymphoma, B-cell lymphoproliferative disorders, flow cytometry, immunophenotype, Matutes score

Diagnostic criteria of lymphoproliferative diseases from the peripheral blood samples using a cell biochip

“…В нашей выборке был 1 пациент с данным диагнозом, однако при исследовании его крови на клеточном биочипе на анти-CD5 не было обнаружено ни связывания значимого количества мононуклеаров, ни клеток с характерной для ЛКМЗ морфологией. Предварительные данные, опубликованные ранее [3], позволяют предположить, что для дифференциальной диагностики двух CD5 + В-ЛПЗ на клеточном биочипе могут быть использованы данные о доле CD23 + и CD200 + клеток и наличии среди них клеток с морфологией опухолевых клеток при ЛКМЗ [14], однако для выработки соответствующих критериев необходимо проведение дополнительных исследований.…”

How to Diagnose and Treat CD5-Positive Lymphomas Involving the Spleen

“…The expression of CD5 on B-cell neoplasms is classically indicative of chronic lymphocytic leukemia (CLL), an indolent neoplasm, or mantle cell lymphoma (MCL), a usually aggressive lymphoma [ 9 ]. Commonly, the expression of Cyclin D1 is present only in MCL, allowing the precise differentiation and appropriate treatment of these entities.…”

“…However, overlapping conditions exist, which demand more sophisticated diagnostic techniques. Although rare, CD5 positivity can also be present in other, mostly indolent, lymphomas, including splenic marginal zone lymphoma, hairy cell leukemia and lymphoplasmacytic lymphoma [ 1 , 2 , 9 , 10 , 11 ]. Aggressive lymphomas are rarely localized exclusively in the spleen.…”

Low-Grade B Cell Lymphoproliferative Disorder Masquerading as Chronic Rhinosinusitis

“…B-cell lymphoproliferative disorders (BLPDs) are a heterogenous group of malignant haematological conditions with a significantly higher incidence in individuals with primary or secondary immunodeficiency [6]. Diagnosis is usually made on the basis of clinical features such as enlarged lymph nodes or splenomegaly and excess fatigue and/or apparent cytopenia and lymphocytosis on a full blood count [7]. Morphological examination demonstrating a lymphocytic increase or abnormality would prompt further immunophenotypic investigations.…”

“…Morphological examination demonstrating a lymphocytic increase or abnormality would prompt further immunophenotypic investigations. Multiparameter flow cytometry on peripheral blood or bone marrow is a rapid and efficient tool for the diagnosis of BLPDs [7].…”