Utilility of flow cytometry as ancillary study to improve the cytologic diagnosis of thyroid lymphomas

Stacchini, Alessandra; Pacchioni, Donatella; Demurtas, Anna; Aliberti, Sabrina; Cassenti, Adele; Isolato, G; Gazzera, Carlo; Veltri, Andrea; Sapino, Anna; Papotti, Mauro; Freddi, M; Palestini, N; Sisto, Gabriella; Novero, Domenico

doi:10.1002/cyto.b.21204

Cited by 22 publications

(16 citation statements)

References 36 publications

(52 reference statements)

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“…FC has been proven to be of great value when there is a diagnostic dilemma between a hematologic and a reactive or inflammatory condition in which the lymphocyte infiltrate mimics lymphoma [22,23]. Small round blue neoplasms such as neuroendocrine tumors or poorly differentiated Ca and melanoma may be another diagnostic dilemma in which FC can contribute to a differential diagnosis towards lymphomas [24,25].…”

Section: Discussionmentioning

confidence: 99%

Single-Tube Flow Cytometry Assay for the Detection of Mature Lymphoid Neoplasms in Paucicellular Samples

Stacchini

Demurtas²,

Aliberti³

et al. 2016

Acta Cytologica

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Objectives: Flow cytometry (FC) has become a useful support for cytomorphologic evaluation (CM) of fine-needle aspirates (FNA) and serous cavity effusions (SCE) in cases of suspected non-Hodgkin lymphoma (NHL). FC results may be hampered by the scarce viability and low cellularity of the specimens. Study Design: We developed a single-tube FC assay (STA) that included 10 antibodies cocktailed in 8-color labeling, a cell viability dye, and a logical gating strategy to detect NHL in hypocellular samples. The results were correlated with CM and confirmed by histologic or molecular data when available. Results: UsingtheSTA, we detected B-type NHL in 31 out of 103 hypocellular samples (81 FNA and 22 SCE). Of these, 8 were not confirmed by CM and 2 were considered to be only suspicious. The FC-negative samples had a final diagnosis of benign/reactive process (42/72), carcinoma (27/72), or Hodgkin lymphoma (3/72). Conclusions: The STA approach allowed obtainment of maximum immunophenotyping data in specimens containing a low number of cells and a large amount of debris. The information obtained by STA can help cytomorphologists not only to recognize but also to exclude malignant lymphomas.

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Section: Discussionmentioning

confidence: 99%

Single-Tube Flow Cytometry Assay for the Detection of Mature Lymphoid Neoplasms in Paucicellular Samples

Stacchini

Demurtas²,

Aliberti³

et al. 2016

Acta Cytologica

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“…The combination of FC and FNA produced 97% sensitivity and 87% specificity for the detection of B-lymphomas [41]. In a recent paper we demonstrated that the combination of FC and FNA produces a sensitivity and specificity of 100% in the detection of NHL of the thyroid [42]. Our paper reports the identification of 12 mature B-cell neoplasms (11 B-cell NHL, 1 Burkitt lymphoma, BL) and 1 case of precursor T-lymphoblastic lymphoma (PTLL) among 35 examined samples.…”

Section: Thyroid Lymphoproliferative Processesmentioning

confidence: 99%

“…The literature that we are aware of that reports the use of FC is listed in table 2[29,30,31,32,33,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58]. Two papers were case reports [48,54]; some included thyroid specimens in studies performed to assess the overall value of FNA in NHL diagnosis [29,30,32].…”

Section: Thyroid Lymphoproliferative Processesmentioning

confidence: 99%

“…Two papers were case reports [48,54]; some included thyroid specimens in studies performed to assess the overall value of FNA in NHL diagnosis [29,30,32]. Among the studies carried out to evaluate the role of cytology in the differential diagnosis of thyroid lymphoproliferative processes, only three reports focused on the role played by FC [42,56,57]. Our study [42] and the work by Boonyaarunnate et al [56] reported the highest number of lymphomas identified, both concluding that the combined use of FNA-FC plays a fundamental role in the identification of this rare form of extranodal lymphoma.…”

Section: Thyroid Lymphoproliferative Processesmentioning

confidence: 99%

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Extranodal Lymphoproliferative Processes and Flow Cytometry

Stacchini¹,

Demurtas²,

Aliberti³

2016

Acta Cytologica

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Objective: Fine-needle aspiration (FNA) cytology is a safe and cost-effective technique for the diagnosis of lymphoproliferative processes, especially when correlated with clinical and imaging studies. However, cytology alone may be unable to detect a lymphoid neoplastic process, as architectural features are less obvious than in histologic preparations and, in certain cases, reactive processes may mimic lymphoma. Flow cytometry (FC) has been recognized as an important ancillary technique in the diagnosis of lymphoid neoplasms and it can be used in conjunction with FNA in the evaluation of lymphoproliferative processes. Study Design: We performed a review of the published literature concerning FC applied to the detection of salivary glands and thyroid lymphoproliferative processes, which are frequently related to autoimmune diseases and difficult to diagnose by cytomorphology alone. Results: FC is able to detect and subtype non-Hodgkin lymphomas and may contribute to the exclusion of a neoplastic process in cytologically unclear cases. Conclusions: FC can be successfully applied in the differential diagnosis of lymphoproliferative processes in the head and neck region. The FNA-FC combined approach can reduce time to therapy and may prevent unnecessary surgical biopsies.

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“…Flow cytometry (FC) is a well‐established technique to investigate hemopoietic disorders widely used to evaluate peripheral blood, bone marrow aspirates and body cavity fluids . In our laboratory, it has been successfully applied not only to “natural” fluids, but also in solid tissues after their disaggregation and in fine‐needle aspirates (FNA) of patients with suspected non‐Hodgkin lymphomas (NHL) . During routine FC immunophenotyping activity, we occasionally encountered cells of nonhemopoietic origin, particularly whenever working with FNA and body cavity fluids; the clue of their presence was mostly related to detection of CD45‐negative (CD45−) cell populations often associated to unusual light scatter.…”

Section: Introductionmentioning

confidence: 99%

Flow cytometry identification of nonhemopoietic neoplasms during routine immunophenotyping

Stacchini

Aliberti

Demurtas

et al. 2018

Int J Lab Hematology

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Introduction Nonhemopoietic neoplasms (NHNs) may be encountered during routine flow cytometry (FC) immunophenotyping. The clue of their presence mainly relies on detection of CD45‐negative (CD45−) cells with altered scatter parameters. Methods In this study, we evaluated a monoclonal antibody combination conceived to characterize the CD45− population by FC, suspected of belonging to NHNs, when present. The panel included CD45 for leucocytes identification, CD326 (clones BerEP4 and HEA‐125) to mark epithelial cells, CD33 to identify myeloid cells, CD138 to trace plasma cells and CD56 useful in the identification of neuroendocrine tumours. 7AAD vital dye was used to gate out dead cells. Results were correlated with cytomorphology and confirmed by histological data, if available. Results Among 9422 specimens submitted for routine FC investigation, 47 samples that included fine‐needle aspirates, bone marrow aspirates, tissue biopsies and body fluids had a detectable CD45− population and a sufficient cell amount to be further investigated. FC revealed the presence of CD326‐positive epithelial cells in 38 specimens; altered scatter parameters and variable reactivity to the other antigens tested allowed to suspect NHNs in the remaining nine samples. The presence of NHNs was confirmed in all cases by morphology. Conclusions The current results show that when CD45− cells with altered scatter parameters were detected, cytometrists involved in leukaemia/lymphoma diagnosis may require further FC investigations to rapidly identify NHNs in different specimens, thus reducing the time of the immunohistochemical diagnostic workup to reach a final diagnosis.

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Utilility of flow cytometry as ancillary study to improve the cytologic diagnosis of thyroid lymphomas

Cited by 22 publications

References 36 publications

Single-Tube Flow Cytometry Assay for the Detection of Mature Lymphoid Neoplasms in Paucicellular Samples

Single-Tube Flow Cytometry Assay for the Detection of Mature Lymphoid Neoplasms in Paucicellular Samples

Extranodal Lymphoproliferative Processes and Flow Cytometry

Flow cytometry identification of nonhemopoietic neoplasms during routine immunophenotyping

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