title: Fine-needle aspiration biopsy and flow cytometry immunophenotyping of lymphoid and myeloproliferative disorders of the spleen.
abstract: BACKGROUND
  Flow cytometry (FC) is a useful adjunct to fine-needle aspiration biopsy (FNAB) in the evaluation of lymphoproliferative disorders. The application of FC to FNAB of the spleen (sFNAB) is reported.
  
  
  METHODS
  Flow cytometry was performed on 18 sFNAB collected over 3 years. The series comprised 10 cases of non- Hodgkin lymphomas (NHL), 2 cases insufficient for diagnosis, 2 cases of reactive hyperplasia (RH), and 4 cases of myeloid metaplasia (MM). FNAB was performed under ultrasound guidance using a 22-gauge needle. One or two passes were sufficient to prepare a conventional smear that was immediately evaluated to select the cases studied and to prepare a cell suspension for FC. The following fluoresceinated antibodies were used: CD3, CD19/kappa/lambda, FMC7/CD23/CD19, Bcl-2, and CD13/HLA-DR. In six cases, cytospins were also prepared for immunocytochemistry and were tested for CD20 (L26), CD45Ro, and kappa and lambda light chain expression.
  
  
  RESULTS
  Flow cytometry contributed to the diagnosis of all cases of NHL by assessing light chain restriction. The specific subtype was also diagnosed by CD19/CD5 and CD 19/CD10 coexpression in two cases. Flow cytometry quantified the percentage of myeloid cells in MM cases and contributed to the cytologic diagnosis showing a polyclonal light chain expression in RH cases. Immunocytochemistry was effective and concordant in four cases. Patients tolerated the sFNAB well and no complications were reported. Cytologic and FC diagnoses were confirmed by follow-up and by histologic evaluation in cases in which splenectomy was performed for therapeutic purposes.
  
  
  CONCLUSIONS
  Flow cytometry applied to sFNAB corroborates the cytologic diagnosis in lymphoid and myeloproliferative disorders of the spleen and allows therapeutic decisions avoiding splenectomy.
authors.affiliation: Dipartimento di Anatomia Patologica e Citopatologia, Facoltà di Medicina e Chirurgia, Università di Napoli "Federico II," Napoli, Italy.
authors.forename: Pio
authors.initials: P
authors.lastname: Zeppa
authors.forename: Marco
authors.initials: M
authors.lastname: Picardi
authors.forename: Gilda
authors.initials: G
authors.lastname: Marino
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Troncone
authors.forename: Franco
authors.initials: F
authors.lastname: Fulciniti
authors.forename: Antonio
authors.initials: A
authors.lastname: Vetrani
authors.forename: Bruno
authors.initials: B
authors.lastname: Rotoli
authors.forename: Lucio
authors.initials: L
authors.lastname: Palombini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018941:Antigens, CD19 / Q000032:analysis / Q000096:biosynthesis; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015260:Neprilysin / Q000032:analysis / Q000096:biosynthesis; D055728:Primary Myelofibrosis / Q000175:diagnosis / Q000473:pathology*; D013154:Spleen / Q000473:pathology*; D013158:Splenic Diseases / Q000175:diagnosis / Q000473:pathology*; D013163:Splenomegaly / Q000209:etiology
chemical_list: D018941:Antigens, CD19; D015260:Neprilysin