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Flow cytometric immunophenotype of canine lymph node aspirates.

Increasing availability of reagents able to distinguish subtypes of lymphocytes and other leukocytes has enabled greater understanding of lymphocyte biology and pathology in the dog. Lymphocytes in circulation most commonly are subjected to immunophenotypic assessment by flow cytometry, but needle aspirates of lymph nodes can be similarly suitable for immunophenotypic examination. In this investigation, the feasibility of immunophenotyping samples obtained by needle aspiration of lymph nodes from 32 dogs with no physical abnormalities and 6 dogs with lymphoma was determined. In addition, samples from 6 dogs were stored overnight at 4 degrees C and reanalyzed 24 hours later. For each sample, stained smear preparations were examined microscopically for lymphocyte morphology, neoplasia, and the presence of inflammatory cells. Expression of antigens on a corresponding sample of aspirated cells was determined by flow cytometric detection of antibody binding on a minimum of 10,000 events. The distribution of data was determined with Anderson-Darling tests, and reference intervals incorporating the central 95% of values were established. Adequate samples were obtained from 30 of 32 clinically normal dogs. Immunophenotypic results after 24 hours of storage were consistent with those obtained immediately after sampling. Reference intervals for lymphocyte subsets from normal dog lymph nodes were similar to the proportions of CD3+, CD4+, CD8+, and CD21+ lymphocytes found in blood. Aspirates of enlarged lymph nodes from dogs with lymphoma were readily classified by this technique. Aspiration of lymph nodes from dogs for comprehensive analysis by flow cytometry is feasible and applicable to immunophenotyping of lymphoma.

Animals↗

Flow cytometric immunophenotyping in fine-needle aspiration of lymph nodes.

Fine-needle aspiration (FNA) of lymph nodes has been regarded as a useful method in the diagnosis of lymphadenopathy. However, this procedure has been shown to be of limited value in the diagnosis of low or intermediate grade malignant lymphomas in some studies. Immunophenotyping is an essential adjunct to cytomorphology for the diagnosis of lymphoma by FNA. Immunophenotyping using flow cytometry (FCM) is rapid, objective and reliable. Using FCM, multiparametric analysis of 33 FNA materials from lymph nodes was performed and profiles of surface markers of lymphoid cells were assessed. In reactive hyperplasia, patterns of cell surface markers were quite variable, but disclosed polyclonality. Most of the B-cell lymphomas showed immunophenotypes for B-cell lineages with their kappa: lambda or lambda: kappa ratio being over 3:1. In T-cell lymphomas, T-cell surface markers were predominantly expressed as well. In conclusion, our results suggest that immunophenotyping of lymph node aspirates is a valuable diagnostic adjunct for lymphoproliferative disorders, particularly in B-cell lymphomas because immunophenotyping can be easily and adequately performed by FCM.

Antigens, CD19↗

Immunophenotyping leukemias: the new force in hematology.

OBJECTIVE: To review basic concepts of immunophenotyping leukemias and introduce clinical laboratory scientists (CLSs) to the technological changes utilized in this laboratory methodology. DESIGN: Literature review. DATA SYNTHESIS: Immunophenotyping in the clinical laboratory is emerging as an advantageous way to separate and classify leukemic malignancies. Immunophenotyping involves the use of flow cytometers and immunofluorescence in order to achieve great sensitivity and specificity for malignant cells. A basic understanding of components of the flow cytometer and how it works is necessary to understand immunophenotyping. Monoclonal antibodies specific to the malignant cells of question play an essential part in this technique. Various fluorescent dyes and cell panels also must be incorporated into the system. Analysis is done and statistics are plotted on dot plots that can be read by the CLS to give helpful insight into the etiology of disease process. Immunophenotyping is a very powerful tool that has the ability to revolutionize the clinical laboratory setting. The CLS working in hematology must become aware of and comfortable with this methodology.

Antibodies, Monoclonal↗

[The features and significance of immunophenotyping in adult acute leukemia].

Immunophenotypic assay was determined by using indirect immunofluorescent method in 120 adult patients with acute leukemia. Eight monoclonal CD antibodies consisting of anti-CD2, -CD7, -CD10, -CD19, -CD13, -CD33, -CD14, and anti-HLA-DR monoclonal antibodies were applied conventionally. The results were that immunophenotyping had high corresponding rate to FAB morphology typing in diagnosing acute leukemia. Also there were some patients who had cross or inverse CD marker expression or no specific CD antigen expression. There were some immunophenotypic features in AML-M3, ALL-L3, and B-Lineage and T-Lineage acute lymphocytic leukemia respectively. Prognostic significance was observed in the patients with specific immunophenotypes, that is acute myeloid leukemia patients with lymphoid antigen (Ly+ AML) and some cases with inverse immunophenotypes.

Adolescent↗

[Immunophenotyping of peripheral blood leukemic cells by multi-parameter cytometry].

AIM: To explore the clinical application and significance of CD45/SCC gating strategy of multi-parameter cytometry and tricolor fluorescence-labeled monoclonal antibodies in immunophenotyping of peripheral blood leukocytes in leukemia. METHODS: Peripheral blood leukocytes were stained with CD45 combined with a panel of monoclonal antibodies to different lineage markers. CD45/SSC dot plot was formed and leukemic cell colony, once displayed, was gated for immunophenotyping. RESULTS: 144 patients with acute leukemia and 51 with chronic leukemia were enrolled. Distinguishable leukemic cell colony was found in 137 out of 144 specimens. 66 patients were immunologically classified as ALL and 67 as AML. 4 patients were unable to be classified immunophenotypically. 27 AL patients coexpressed markers of another cell lineage (20%). Immunophenotypic features of different types of leukemia were described. It is a common phenomenon that AL of one lineage coexpressed markers of another lineage. CONCLUSION: An accurate immunophenotyping of leukemia can be realised when leukemic cell colony is displayed and analyzed by CD45/SCC pattern and gating strategy, which is important for clinical treatment and prognosis judgment.

Adolescent↗

[Characteristics and clinical significance of immunophenotype in chronic lymphocytic leukemia].

OBJECTIVE: To investigate the characteristics of immunophenotype of chronic lymphocytic leukemia (CLL) and to evaluate the prognosis of CLL by using the indexs of the characteristics of immunophenotype combined with serum LDH and beta2-MG levels. METHODS: The immunophenotype of 15 CLL, 12 AML, 11 ALL, and 1 FCL (follicular cell lymphoma) patients were analyzed by the indirect immunofluorescent assay. The serum LDH and beta2-MG were detected in 13 CLL patients by the rate nephelometry. RESULTS: The mean age of episode for CLL was 62.9 years and the ratio of male to female was 4:1 in the CLL group. The immune markers (CD5, CD19, and CD20) were positive in the 15 CLL, and negative in the 11 ALL and the 12 AML. The expression of CD23 was positive in 12 of the 15 CLL and negative in the 11 ALL and 12 AML. The expression of CD38 was positive in the 15 CLL. The immunophenotype of 1 FCL was CD10+, CD19+, CD20+, CD5- and CD23-. The serum beta2-MG and LDH levels in 9 CLL patients at Stage Binet C were significantly higher than those in 3 CLL patients at Stage Binet A (P < 0.05). CONCLUSION: CD19+, CD20+ and CD5+ are specific assembly of immunophenotype in B-CLL and contribute to the diagnosis of CLL. The clinical stage of CLL patients of CD23- belongs to Stage Binet C, indicating the poor prognosis. CD23 contributes to differentiate CLL from FCL. CD38+ as a prognostic marker of CLL is not specific. The levels of LDH and beta2-MG are useful indexes for evaluating the prognosis of CLL.

Aged↗

[Comparison of the immunophenotype of patients with B lineage acute lymphoblastic leukemia at diagnosis and relapse].

OBJECTIVE: To compare the leukemia-associated immunophenotypes (LAIP) in patients with B lineage acute lymphoblastic leukemia (B-ALL) at diagnosis and relapse, and investigate its implications for minimal residual disease (MRD) detection. METHODS: The immunophenotype of leukemia cells from 410 newly diagnosed and 6 relapsed patients with B-ALL were detected by four to six antibody combination, mainly CD34/CD10/CD45/CD19 of 4-color CD45/SSC gating flow cytometry (FCM). RESULTS: The proportion of CD45 under-expressed or negative in relapsed patients was much higher than that in newly diagnosed patients, being 69.2% and 37.8% respectively. Immunophenotypic changes occurred in 9 relapsed patients (including 8 hematological relapse and 1 central nerves system relapse) when analyzed by paired samples analysis at diagnosis vs at relapse: 4 cases showed CD45 down-modulation and 2 up-modulation; 4 CD34 down-modulation and 2 CD10 up-modulation, while the expression of CD19 remained no change. MRD was observed in all 7 cases of hematological relapse 2 - 4 months before relapse, and the immunophenotype of MRD cells was the same as that in relapse. CONCLUSION: A high frequency of immunophenotypic changes occurred at relapse and even in MRD before relapse, however the accuracy of MRD monitoring seemed not affected by the FCM strategy used in this investigation.

Adolescent↗

Acute leukemia after a primary myelodysplastic syndrome: immunophenotypic, genotypic, and clinical characteristics.

We studied the nature of blast cells in 41 patients with acute leukemia following a previous primary myelodysplastic syndrome (MDS) by a combined multiparameter analysis including morphologic, immunophenotypic, and molecular genetic (Igs, T-cell receptor (TCR)-beta, -gamma, and -delta and the major breakpoint cluster region [M-bcr]) investigations. In addition, the clinical and hematologic characteristics according to the immunophenotype of blast cells were analyzed. Our results show that, although the granulocytic and/or monocytic lineages are those most commonly involved in these acute leukemias, other cell components, including the megakaryocytic and lymphoid, may be present (12% and 15% of the cases, respectively). Moreover, both morphologic and phenotypic studies show the frequent coexistence of two or three cell populations. Interestingly, in all cases the lymphoblastic component constantly displayed an early B phenotype (CD19+, CD10-, TdT+). Upon analyzing whether the type of MDS conditioned any differences in the immunophenotype of blast cells, we observed that, although the lymphoid lineage may be involved in all MDS subgroups, some differences emerge within the myeloid leukemic transformations. Thus, the refractory anemias with excess of blasts (RAEB) and RAEB in transformation displayed a significantly higher incidence of myeloblastic and megakaryoblastic transformations, while in the RA, RA with ring sideroblasts and chronic myelomonocytic leukemia, the granulo-monocytic phenotype predominated. In addition, our results show that the clinical and hematologic characteristics of these patients may be partially related to the immunophenotype of the blast cells. Ig heavy chain gene rearrangements were found in two of 19 patients analyzed (11%), one with a hybrid leukemia (lymphoid-myeloid) and the other with a granulo-monocytic phenotype. Two other hybrid transformations analyzed were in germline configuration. Gamma and delta gene rearrangements were found in 21% and 37% of these acute transformation, respectively. The TCR-beta and M-bcr were in germline configuration in all 19 cases studied. In summary, immunophenotype and molecular studies point to a pluripotent stem cell with preferential myeloid commitment as the target cell of leukemias following a primary MDS.

Acute Disease↗

Immunophenotypic and genotypic characterization of primary non-Hodgkin's lymphoma of the gastrointestinal tract.

Antigen receptor gene rearrangement studies have been applied to gastrointestinal (GI) lymphoid proliferations in only a limited number of cases, and their use and contribution to the diagnosis and characterization of GI lymphomas is unknown. We retrospectively studied 17 cases of primary GI lymphoma using fresh/frozen tissue with a combination of immunophenotypic and genotypic techniques. The vast majority of the neoplasms were B-cell lymphomas (88%) with rare T-cell tumors. The most common B-cell immunophenotype was IgM-kappa (40%), while five of the B-cell lymphomas (33%) lacked surface light chain immunoglobulin. Immunophenotypic evidence of histiocytic differentiation was not identified. Clonality was confirmed in 59% (10/17) of the neoplasms by immunophenotyping and 88% (15/17) by antigen receptor gene rearrangement studies. All of the 15 B-cell lymphomas (100%) demonstrated clonally rearranged immunoglobulin gene rearrangement. The two lymphomas with T-cell immunophenotypes did not demonstrate T-cell receptor beta-chain gene rearrangement. Antigen receptor gene rearrangement data can be useful and may even be necessary in certain cases for the proper classification and/or diagnosis of GI lymphoid proliferations.

Adult↗

Pleomorphic large cell hemato-lymphoma (the so-called "malignant histiocytosis"): clinicopathological and immunophenotypic studies in 35 cases.

Thirty-five patients diagnosed with "malignant histiocytosis" from 1984 to 1989 were studied for clinical, laboratory, histopathological features as well as survival and response to therapy, Immunocytochemistry and immunophenotypic studies were performed in 12 cases using the paraffin immunoperoxidase method. The staining included alpha-1 antichymotrypsin, muramidase, immunoglobulins and monoclonal antibodies specific for T, B lymphocytes and macrophage. From the clinical features, responsiveness to therapy and survival, the patients were divided into 2 groups: the non-responders (25 cases) and responders (10 cases) groups. Very short median survival of 1.25 months was found in the non-responders, whereas, longer median survival of 14.15 months was found in the responder group. Important different clinical and laboratory features were observed among these two groups. Unresponsiveness to treatment; rapidly progressive pancytopenia, increased hemophagocytosis, presentation of immature cells in blood with extensive infiltration of malignant cells in the bone marrow; severe jaundice and deterioration of hepatic function accompanied by early extranodal involvement were almost exclusively observed initially in the non-responder group. Satisfactory response to treatment was observed only in the responder group. Similarity of histopathology, cytology and immunophenotype was observed in these two groups. The immunophenotypic study in 12 cases showed 5 cases of B-cell lymphoma, 3 cases of T-cell (with 1 Ki-1 -positive) lymphoma; 1 case of Ki-1 positive non-T, non-B anaplastic large cell lymphoma; and 3 cases of undetermined cell lineage. From this study, so-called "malignant histiocytosis" appears to be a disorder of heterogeneity. The immunophenotypes of malignant cells indicated that their origin belonged mostly to lymphoid cell lineage. Based on their clinical feature of the early hematogenous spread along with the distinct histopathological and immunophenotypic findings, the term "pleomorphic large cell hematolymphoma" is proposed to be used instead of the old misnomer, "malignant histiocytosis" (MH).

Adolescent↗

[Immunophenotype of blast crisis in chronic myeloid leukemia].

The blast crisis in chronic myeloid leukaemia (CML) is morphologically well defined. The aim of this report was to analyze whether immunophenotyping can divide CML blast crises into subtypes as is done in acute de novo leukaemia, and whether a specific CML pattern exists. Between 1991 and 1997 we reevaluated all the immunophenotypes of patients with CML blast crises with special regard to immunological subclassification, expression of CD34, presence of aberrant markers and number of immunological clusters. Twenty-nine CML blast crises were analyzed. Seventeen were myeloid, 11 lymphoid and one biphenotypic. The blast crises were divided into subtypes as de novo acute leukaemias: of the 17 myeloid blast crises 6 were undifferentiated, 5 differentiated and 6 had monocytic differentiation. In the lymphoid blast crises there were no pro-B, 8 common-B and 3 mature-B. No T-lymphoid blast crises were observed. In 26/29 analyses (90%) CD34 was expressed in the blasts. In 17/29 analyses (59%) one or two aberrant markers were found. In summary, immunophenotyping is important in distinguishing between myeloid and lymphoid blast crises. A subclassification, as in acute leukaemias, is possible. We found no specific immunophenotypic CML pattern. A study directly comparing immunophenotyping of CML blast crises with acute de novo leukaemia is planned.

Adolescent↗

Routine immunophenotyping of acute leukaemias.

Recent progress in immunophenotyping includes the availability of monoclonal antibodies (MAbs), knowledge of specificity and reactivity patterns of these reagents, and the technical improvements and standardization of immunofluorescence and immunocytology staining procedures, including flow cytometry. These advances have contributed significantly to the establishment of immunophenotyping as an essential diagnostic tool in the differential diagnosis of types of acute leukaemia. Immunophenotyping allows for the objective and reproducible distinction of acute lymphoblastic leukaemia (ALL) from acute myeloblastic leukaemia (AML) and of T-lineage from B-lineage ALL. Immunologically defined ALL and AML subtypes have been found to convey prognostic significance. Using cell lineage-specific and differentiation stage-specific MAbs, cases of T- and B-lineage ALL and of AML can be further classified into a number of different subtypes. Routine immunophenotyping concentrates on the diagnostic enquiry into a few major, clinically relevant subtypes; only a limited number of crucial reagents are employed that are commercially available. The simplification and standardization of discriminatory immunomarker panels make immunophenotyping a reliable diagnostic instrument for the provision of critical data to make a differential diagnosis. An effort to identify the nature and origin of the blast cells precisely, immunological typing definitely plays an important part in the multiple-marker analysis of acute leukaemia (morphology, cytochemistry, karyotyping, genotyping) for applied diagnostic and fundamental research purposes.

Acute Disease↗

An automated method to prepare cell suspensions from human biopsy samples for immunophenotyping by flow cytometry.

A comparison was made between a manual and automated method for preparing single cell suspensions from various types of human biopsy samples. The automated method uses the shearing action of fluid movement generated by a reciprocating paddle system. When compared on 11 samples, the automated instrument always isolated cells in less time, usually requiring only 15-30 seconds in contrast to 10-15 minutes for the manual method. The time comparisons involved "set up" time of the required minor equipment as well as the time to make a complete single cell suspension from the portion of the biopsy sample sent to the Flow Cytometry Lab so extra cells could be used for other purposes and cryogenically stored for future reference. Cells isolated by the automated method from various B-lymphocytic and T-lymphocytic malignancies were still viable and could be successfully immunophenotyped by flow cytometry. The immunophenotyping results were compared for both cell isolation methods on seven of these samples, and the results were comparable. The automated technique has now been used to satisfactorily immunophenotype more than 50 biopsy samples. The automated method should represent a significant aid for clinical flow cytometry laboratories performing immunophenotyping tests by efficiently preparing single cell suspensions in a few seconds instead of minutes. Furthermore, the automated method uses a closed sterile bag system that helps minimize the exposure of personnel to potential infectious material present in biopsy samples and prevents external contamination of cell suspensions. The automated technique proven successful for immunophenotyping may also be helpful for related procedures involving hematopoietic malignancies such as DNA content analysis and cell functional assays by flow cytometry, as well as other assays such as tissue typing, gene probe, and in vitro chemosensitivity assays.

Antigens, CD↗

Clinical significance of immunophenotype in diffuse aggressive non-Hodgkin's lymphoma.

We performed a prospective study of the clinical significance of immunophenotype in 110 patients with aggressive non-Hodgkin's lymphoma (NHL) treated by oncologists in the Nebraska Lymphoma Study Group between October 1982 and May 1986. All patients were immunophenotyped from biopsies performed before therapy was administered. The patients were treated with a uniform protocol of radiotherapy for minimal nonbulky, stage I or II disease (seven patients) or a single, six-drug chemotherapy regimen cyclophosphamide, doxorubicin, procarbazine, bleomycin, vincristine, and prednisone (CAP-BOP) in patients with more extensive disease (103 patients). Ninety-one patients (83%) had B-cell lymphoma and 19 patients (17%) had T-cell lymphoma. The histologic diagnosis of diffuse mixed-cell lymphoma was significantly associated with T-cell immunophenotype (45% v 5%; P less than .001), and the diagnosis of diffuse large-cell lymphoma was significantly associated with B-cell immunophenotype (40% v 5%; P = .006). However, no significant difference in frequency of prognostic variables such as age, stage, systemic symptoms, tumor bulk, serum lactic dehydrogenase, or performance status was found between the B-cell and T-cell groups. Patients with B-cell NHL had a slightly higher complete remission rate (74% v 53%; P = NS), similar durability of complete remission (75% v 70% at 3 years; P = NS), and a slightly but not significantly better overall survival (50% v 41% at 3 years; P = NS). The slight advantage in response rate and survival for B-cell patients was related to a very poor outcome for patients with stage IV T-cell NHL. For patients with stage I to III disease, neither the complete remission rate (B-cell, 82% v T-cell, 91%; P = NS) nor overall survival (3-year survival for B cell, 58% v T cell, 73%; P = NS) were significantly different. However, with stage IV disease B-cell patients fared far better than those with T-cell NHL for both complete remission rate (67% v 0%; P = .002) and overall survival (3-year survival, 44% v 0%; P = .002). Immunophenotyping intermediate- and high-grade NHL allowed identification of a subgroup of patients who had a very poor prognosis with this treatment approach and for whom alternate therapy might be considered.

Antigens, CD↗

The diagnostic utility of immunophenotyping and immunogenotyping in the pathologic evaluation of lymphoid proliferations.

One hundred eighty-two specimens of suspected lymphoma and lymphocytic leukemia were examined by morphology, immunophenotype, and immunogenotype (genotype) in order to answer the following questions: How often and in what situations does immunophenotyping help resolve a diagnostic problem that is not resolved by morphology? How frequently does genotyping help resolve a diagnostic problem that is not resolved by morphology and immunophenotyping? Of 182 cases for which fresh tissue was available, sixty-five cases were considered morphological diagnostic problems: There were 32 cases of neoplasia versus non-neoplastic proliferation, 16 cases of neoplasia with undifferentiated or ambiguous morphology, and 17 cases of lymphoma or lymphocytic leukemia with an uncertain subtype. Immunophenotyping helped to resolve 33 of these 65 cases. Of the remaining 32 cases genotyping helped to resolve the diagnosis in 16. These results suggest that immunophenotyping may diagnose approximately 50% of those cases which present a morphological problem, and that genotyping is also helpful in a limited but significant number of problem cases.

Diagnosis, Differential↗

The contribution of cytochemistry and immunophenotyping to the reproducibility of the FAB classification in acute leukemia.

Intraobserver and interobserver reproducibility of the FAB classification was assessed for two independent observers whose decisions are acted on for treatment of patients with acute leukemia in the Hamilton region. Intraobserver reproducibility was assessed for Wright-stained preparations that were examined independently on two consecutive occasions at least 2 weeks apart. A third reading was performed with Wright stain and cytochemical data, and the fourth reading was done with addition of immunophenotype data. Concordance was calculated using a statistic that corrects for chance-expected agreement (k), and a weighted statistic that takes into account the seriousness of disagreements was used. Samples were available for morphological and cytochemical assessment on 105 patients, and immunophenotype data were available on 93 specimens. Intraobserver concordance was 64.8% and 70.5% for observers A and B, respectively, with kappa values of .56 and .62. There were 37 discordant readings for observer A and 31 for observer B, with each observer discordant between lymphocytic:nonlymphocytic phenotypes in ten cases. Concordance between observers was 63% (k = .54) and 72% (k = .65) for each of two separate readings for Wright-stained preparations only. Reproducibility improved to 89% (k = .86) when cytochemistry was added. When immunophenotype information was provided in addition to Wright-stained and cytochemical preparations, the agreement was 99%. Lymphocytic:nonlymphocytic discordance between observers occurred on nine occasions when Wright-stained preparations only were available and four times when cytochemistry was added; it did not occur with immunophenotyping. The study suggests that immunophenotyping, when added to morphological assessment of acute leukemia, may contribute substantially to agreement between observers.

Antigens, Neoplasm↗

Automated classification of patients with chronic lymphocytic leukemia and immunocytoma from flow cytometric three-color immunophenotypes.

The goal of this study was the discrimination between chronic lymphocytic leukemia (B-CLL), clinically more aggressive lymphoplasmocytoid immunocytoma (LP-IC) and other low-grade non-Hodgkin's lymphomas (NHL) of the B-cell type by automated analysis of flow cytometric immunophenotypes CD45/14/20, CD4/8/3, kappa/CD19/5, lambda/CD19/5 and CD10/23/19 from peripheral blood and bone marrow aspirate leukocytes using the multiparameter classification program CLASSIF1. The immunophenotype list mode files were exhaustively evaluated by combined lymphocyte, monocyte, and granulocyte (LMG) analysis. The results were introduced into databases and automatically classified in a standardized way. The resulting triple matrix classifiers are laboratory and instrument independent, error tolerant, and robust in the classification of unknown test samples. Practically 100% correct individual patient classification was achievable, and most manually unclassifiable patients were unambiguously classified. It is of interest that the single lambda/CD19/5 antibody triplet provided practically the same information as the full set of the five antibody triplets. This demonstrates that standardized classification can be used to optimize immunophenotype panels. On-line classification of test samples is accessible on the Internet: http://www.biochem.mpg.de/valet/leukaem1.html Immunophenotype panels are usually devised for the detection of the frequency of abnormal cell populations. As shown by computer classification, most the highly discriminant information is, however, not contained in percentage frequency values of cell populations, but rather in total antibody binding, antibody binding ratios, and relative antibody surface density parameters of various lymphocyte, monocyte, and granulocyte cell populations.

Antibodies↗

Combined cytomorphologic and immunophenotypic approach to evaluation of effusions for lymphomatous involvement.

Combining cytomorphology and immunophenotypic data in evaluation of effusions for lymphomatous involvement is reliable, non-invasive, and expeditious. In this study, 30 effusion specimens from 30 patients with clinically suspected or previously diagnosed non-Hodgkin's lymphoma (NHL) were evaluated cytomorphologically and by flow cytometric immunophenotyping with a large panel of monoclonal antibodies. Of 11 patients with a previous diagnosis of NHL, 50% had cytomorphologic and immunophenotypic evidence of lymphomatous involvement of effusion specimens; therefore, flow cytometric immunophenotyping is recommended in these cases since there may be substantial therapeutic impact. In addition, 69% of the effusions positive for lymphomatous involvement represented newly diagnosed NHL; in 36% of these cases, tissue biopsy was not necessary since they were either high-grade (lymphoblastic or small, non-cleaved cell type) or of the small lymphocytic lymphoma cell type.

Antigens, CD↗