Early and reliable diagnosis of non-Hodgkin lymphoma in childhood and adolescence: contribution of cytomorphology and flow cytometric immunophenotyping.
Non-Hodgkin lymphoma (NHL) represents one of the most rapidly growing malignancies in childhood and adolescence. About 80% of patients now are cured with adequate treatment. Serious complications at presentation due to tumor lysis syndrome or local tumor effects are commonly observed. Thus, a rapid diagnosis with the least invasive procedure enabling the initiation of early and specific therapy is necessary to diminish early fatality or persistent impairment. In 56 centrally registered patients with NHL, cytomorphologic analyses (FAB criteria) of May-Grünwald-Giemsa-stained touch imprints or malignant effusions and flow cytometric immunophenotyping (EGIL criteria) of fresh cell suspensions with a standardized panel of monoclonal antibodies were performed. The authors identified 23 patients with Burkitt lymphoma by the combination of FAB L3 morphology and a mature B-cell phenotype and 22 patients with lymphoblastic lymphoma by FAB L1/L2 morphology and a T-/B-cell precursor phenotype. They also found 11 patients with large cell lymphomas, 3 of them with anaplastic large cell lymphoma (T-cell phenotype; NPM/ALK-positive). In the remaining 8 patients diffuse large B-cell lymphoma was suspected by the combined use of cytologic and immunophenotypic findings (mature B-cell phenotype). In all cases with available solid tumor material (n = 42/56) the preliminary diagnosis was confirmed by histopathology. Burkitt lymphoma, lymphoblastic lymphoma, and, in a few cases, some large cell lymphomas could be classified reliably by cytomorphology and immunophenotyping of freshly obtained tumor cell material, enabling an early start of specific lymphoma treatment.
Mann
Georg
G
St. Anna Children's Hospital, Vienna, Austria. Mann@stanna.at
Attarbaschi
Andishe
A
Steiner
Manuel
M
Simonitsch
Ingrid
I
Strobl
Herbert
H
Urban
Christian
C
Meister
Bernhard
B
Haas
Oskar
O
Dworzak
Michael
M
Gadner
Helmut
H
D000008:Abdominal Neoplasms / Q000145:classification / Q000175:diagnosis / Q000473:pathology; D000293:Adolescent; D015703:Antigens, CD / Q000032:analysis; D001317:Austria / Q000453:epidemiology; D044963:Biopsy, Fine-Needle; D002051:Burkitt Lymphoma / Q000175:diagnosis / Q000473:pathology; D002467:Cell Nucleus / Q000648:ultrastructure; D048429:Cell Size; D002648:Child; D002675:Child, Preschool; D003584:Cytological Techniques; D003593:Cytoplasm / Q000648:ultrastructure; D042241:Early Diagnosis; D005240:Feasibility Studies; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D007223:Infant; D016131:Lymphocyte Subsets / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008479:Mediastinal Neoplasms / Q000145:classification / Q000175:diagnosis / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000473:pathology; D011446:Prospective Studies; D013194:Staining and Labeling
D015703:Antigens, CD