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4. Hrvatski kongres kliniËke citologije 4th Croatian Congress ... - Penta

4. Hrvatski kongres kliniËke citologije 4th Croatian Congress ... - Penta

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Analytical Cytology - Plenary and Invited Lectures<br />

FLOW CYTOMETRIC CLONALITY ANALYSIS OF ENDOSCOPIC ULTRASOUND-GUIDED<br />

FINE-NEEDLE ASPIRATION OF LYMPH NODES<br />

Miletić Z1 , Gizdić G2 , Štoos-Veić T1 , Kaić G1 , Novak NP1 , Tadić M3 , Jakšić O2 ,<br />

Trutin Ostović K1 1Department of clinical cytology and cytometry, Dubrava University Hospital, Zagreb,<br />

Croatia<br />

2Clinic of internal medicine, Department of hematology, Dubrava University Hospital,<br />

Zagreb, Croatia<br />

3Clinic of internal medicine, Department of gastroenterology, Dubrava University<br />

Hospital, Zagreb, Croatia<br />

Immunophenotyping by flow cytometry (FC) is an essential tool in the diagnosis of<br />

non-Hodgkin’s lymphomas (NHLs) in fine-needle aspiration cytology (FNAC) of palpable<br />

lymph nodes or endoscopic ultrasound-guided (EUS) FNAC of deep-seated lymph<br />

nodes. Because at least 80% of NHLs are of B-cell type, detection of immunoglobulin<br />

(Ig) light-chain-restriction (clonality) represents the most commonly used evidence for<br />

a diagnosis of B-cell lymphoma. In our study we wanted to evaluate accuracy of FC<br />

clonality compared to morphologic diagnosis of EUS-FNA of deep-seated lymph nodes.<br />

Direct smears were made and selected slide was stained for rapid-on site evaluation<br />

procedure and if needed additional samples were sent for FC clonality analysis. Sixteen<br />

patients with suspicious NHL of deep-seated lymph nodes obtained by EUS-FNA were<br />

submitted for FC clonality analysis. Six of the patients had supected pancreatic lesions,<br />

6 had abdominal and 4 had mediastinal lesion. Adequacy of samples with diagnostically<br />

relevant material were 68,7%. Monoclonality was demonstrated in 7 of 11 cases cytologically<br />

diagnosed as NHL. Polyclonality was demonstrated in 4 of 11 cases cytologically<br />

diagnosed as benign reactive lymphadenopathy. Our results show that EUS-FNAC with<br />

FC is a sensitive and specific tool in the diagnosis of deep-seated B-NHL. Successful<br />

cytologic diagnosis combined with FC clonality analysis can be performed in majority of<br />

cases and may eliminate need for open biopsy, especially in relapsed disease.<br />

zorana.miletic@kbd.hr<br />

157<br />

4 th <strong>Croatian</strong> <strong>Congress</strong> of Clinical Cytology / 1 st <strong>Croatian</strong> Symposium of Analytical Cytology / 2 nd <strong>Croatian</strong> Symposium of Cytotechnology

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