title: Flow cytometric analysis of deep-seated lymph nodes.
abstract: Flow cytometry (FC) immunophenotyping is an important tool in the evaluation of lymphadenopathy and is widely used in the diagnosis of non-Hodgkin's lymphomas (NHLs) on fine-needle aspirates of lymph nodes and extranodal sites. Because at least 80% of NHLs are of B-cell type, detection of immunoglobulin (Ig) light-chain-restriction is the most commonly used method for confirmation of monoclonality. The aim of our study was to evaluate usefulness of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for FC analysis from deep-seated lymph nodes and to compare results of FC clonality analysis to cytomorphologic diagnosis of sampled lymph nodes. For cytological diagnosis direct smears were made, selected slide was stained for rapid-on site evaluation procedure. Sixteen patients with suspected NHL of deep-seated lymph nodes obtained by EUS-FNA were submitted for FC clonality analysis using four-color multiparameter flow cytometry stained with kappa/lambda/CD19/CD45. Clonality analysis was performed on 11 samples. Monoclonality was demonstrated in seven of 11 cases cytologically diagnosed as NHL and four of 11 cases cytologically diagnosed as benign were polyclonal. Our results show that EUS-FNAC with FC is a sensitive and specific tool in the diagnosis of deep-seated B-NHL. Cytologic diagnosis combined with FC clonality analysis can be performed in majority of cases and may eliminate need for open biopsy in some cases.
authors.affiliation: Department of Clinical Cytology and Cytometry, Dubrava University Hospital, Zagreb, Croatia. zorana.miletic@kbd.hr
authors.forename: Zorana
authors.initials: Z
authors.lastname: Miletić
authors.forename: Branimir
authors.initials: B
authors.lastname: Gizdić
authors.forename: Tajana
authors.initials: T
authors.lastname: Stoos-Veić
authors.forename: Gordana
authors.initials: G
authors.lastname: Kaić
authors.forename: Nina-Petra
authors.initials: NP
authors.lastname: Novak
authors.forename: Mario
authors.initials: M
authors.lastname: Tadić
authors.forename: Ozren
authors.initials: O
authors.lastname: Jaksić
authors.forename: Karmen Trutin
authors.initials: KT
authors.lastname: Ostović
mesh_terms: D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000235:genetics; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography
chemical_list: D007147:Immunoglobulin Light Chains