title: Diagnosis of leptomeningeal disease in diffuse large B-cell lymphomas of the central nervous system by flow cytometry and cytopathology.
abstract: Reliable detection of leptomeningeal disease has the potential of facilitating the diagnosis of central nervous system (CNS) lymphoma and is important for therapeutic considerations. Currently, the standard diagnostic procedure for the detection of lymphoma in the cerebrospinal fluid is cytopathology. To improve the limited specificity and sensitivity of cytopathology, flow cytometry has been suggested as an alternative. Here, we evaluated multi-parameter flow cytometry in combination with conventional cytopathology in cerebrospinal fluid (CSF) samples from 30 patients with primary CNS lymphoma and seven patients with secondary CNS lymphoma. Overall, in 11 of 37 (29.7%) patients with CNS lymphoma, lymphoma cells were detected in CSF by flow cytometry, while cytopathology was less sensitive displaying unequivocally malignant CSF cells in only seven of all 37 (18.9%) patients. Six (16.2%) patients showed cytopathological results suspicious of lymphoma; however, in only one of these patients, the diagnosis of CSF lymphoma cells could be confirmed by flow cytometry. In primary CNS lymphomas (PCNSL), seven of 30 (23.3%) patients were positive for CSF lymphoma cells in flow cytometry, in contrast to four (13.3%) patients with PCNSL with definitely positive cytopathology. In summary, our results suggest that multi-parameter flow cytometry increases the sensitivity and specificity of leptomeningeal disease detection in CNS lymphomas. Both methods should be applied concurrently for complementary diagnostic assessment in patients with CNS lymphoma.
authors: Department of Medicine, Hematology and Oncology, Ruhr-University of Bochum, Bochum, Germany. Roland.Schroers@rub.de
authors: Roland
authors: R
authors: Schroers
authors: Alexander
authors: A
authors: Baraniskin
authors: Christoph
authors: C
authors: Heute
authors: Matthias
authors: M
authors: Vorgerd
authors: Anna
authors: A
authors: Brunn
authors: Jan
authors: J
authors: Kuhnhenn
authors: Annika
authors: A
authors: Kowoll
authors: Andriy
authors: A
authors: Alekseyev
authors: Wolff
authors: W
authors: Schmiegel
authors: Uwe
authors: U
authors: Schlegel
authors: Martina
authors: M
authors: Deckert
authors: Hendrik
authors: H
authors: Pels
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000134:cerebrospinal fluid* / Q000473:pathology*; D008297:Male; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid* / Q000473:pathology* / Q000556:secondary*; D008875:Middle Aged