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

4. Hrvatski kongres kliniËke citologije / 1. Hrvatski simpozij analitiËke citologije / 2. Hrvatski simpozij citotehnologije
LYMPH NODE FINE NEEDLE ASPIRATION - SAMPLE ADEQUACY FLOW CYTOMETRY
IMMUNOPHENOTYPING
Švencbir V1 , Milas M2 , Anić V2 , Šiftar Z2 , Kardum Paro MM2 , Kardum-Skelin I2 1 Sestre Milosrdnice University Hospital, Zagreb, Croatia
2 Merkur University Hospital, Zagreb, Croatia
In a modern clinical laboratory, lymphatic cell immunophenotyping by flow cytometry
helps determine the diagnosis of clonal B-lymphocytes and thus discriminate benign
from malignant lymphoproliferative diseases. The aim of the study was to assess adequacy
and appropriateness of lymph node fine needle aspiration (FNA) for flow cytometry
analysis in cases of benign and primary malignant disorders. The study was based
on medical documentation, cytologic smear of FNA lymph node sample and flow cytometry
immunophenotyping results. The study included 239 patients during the 2006-2007
period. According to cytologic test results, patients were classified into several groups:
benign lymphoproliferative disease (22%), undefined monomorphous population of lymphatic
cells (16%), B cell non-Hodgkin’s lyphoma (55%), and non-B cell non-Hodgkin’s
lyphoma (5%). Lymphocytes were isolated from FNA lymph node samples using density
gradient. The suspension of mononuclear cells was labeled by appropriate combination
of negative control and monoclonal antibodies and then analyzed by flow cytometry. The
acceptable minimum number of cells from lymph node sample as representative for
flow cytometry analysis was determined by maximal control of electronic gates around
the specific cell population. In the study material, 85% of samples contained an adequate
cell quantity for analysis, in 12% of samples the number of cells was only adequate
to determine clonality, whereas in 3% of samples the number of cells was inadequate
for any analysis. Although cell adequacy for analysis varied among groups, there was
no statistically significant difference in the adequacy of samples obtained from patients
with benign lymphoproliferative diseases (87%), monomorphous population of lymphatic
cells (76%), B cell non-Hodgkin’s lymphoma (89%) and non-B cell lymphoma (69%). In
conclusion, cytologic diagnosis of lymphoproliferative disease is a simple and reliable
diagnosis in both separation of benign from primary lymphoproliferative diseases (lymphoma)
and secondary malignancies, as well as in tissue typing and subtyping of malignant
lymphoma. Since FNA provides enough cells for flow cytometry analysis, these two
diagnostic methods improve diagnostic accuracy and safety
viktorija_svencbir@net.hr
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