title: [Lineage assignment in acute leukemia: confrontation between cytology and immunophenotyping].
abstract: OBJECTIVE
  The determination of the cellular lineage in acute leukemia is a crucial step in the diagnosis and the later therapeutic conduct. In Tunisia, emerging country, some cases of acute leukemias are still treated on the basis of an only cytologic study because of lack of cytometry. Our objective is to realize a confrontation between cytology and flow cytometry in the diagnosis of AL and to analyze discrepancies.
  
  
  METHODS
  The study concerns 100 cases of AL. A second double-blind examination of the bone marrow smears of acute leukemias is realized by two cytologists and confronted to immunophenotyping.
  
  
  RESULTS
  In two cases of AML, flow cytometry reassigned lineage into T ALL and biphenotypic AL. In three cases of ALL the lineage was reassigned into undifferentiated acute leukemia (2 cases) and biphenotypic acute leukemia (1 case). Lineage was not established in four cases, immunophenotyping allowed the diagnosis of B ALL in 3 cases, and of biphenotypic acute leukemia in 1 case. In both cases of discrepant findings, flow cytometry allowed the diagnosis of biphenotypic acute leukemia in a case and of AML in the other one.
  
  
  CONCLUSIONS
  The cytological study remains insufficient in the diagnosis of lineage even with experimented cytologists. Immunophenotyping is essential in lineage assignment and reassignment.
authors.affiliation: Département d'hématologie, faculté de médecine de Tunis, université Tunis El Manar, rue Jebel Lakhdar, Tunis, Tunisie. Electronic address: naouel-bsalah@voila.fr.
authors.forename: N
authors.initials: N
authors.lastname: Ben Salah
authors.affiliation: Département d'hématologie, faculté de médecine de Tunis, université Tunis El Manar, rue Jebel Lakhdar, Tunis, Tunisie.
authors.forename: W
authors.initials: W
authors.lastname: El Borgi
authors.affiliation: Département d'hématologie, faculté de médecine de Tunis, université Tunis El Manar, rue Jebel Lakhdar, Tunis, Tunisie.
authors.forename: A
authors.initials: A
authors.lastname: Chelbi
authors.affiliation: Département d'hématologie, faculté de médecine de Tunis, université Tunis El Manar, rue Jebel Lakhdar, Tunis, Tunisie.
authors.forename: F
authors.initials: F
authors.lastname: Ben Lakhal
authors.affiliation: Département d'hématologie, faculté de médecine de Tunis, université Tunis El Manar, rue Jebel Lakhdar, Tunis, Tunisie.
authors.forename: E
authors.initials: E
authors.lastname: Gouider
authors.affiliation: Département d'hématologie, faculté de médecine de Tunis, université Tunis El Manar, rue Jebel Lakhdar, Tunis, Tunisie.
authors.forename: H
authors.initials: H
authors.lastname: Aounallah Skhiri
authors.affiliation: Département d'hématologie, faculté de médecine de Tunis, université Tunis El Manar, rue Jebel Lakhdar, Tunis, Tunisie.
authors.forename: R
authors.initials: R
authors.lastname: Hafsia
mesh_terms: D000208:Acute Disease; D015703:Antigens, CD / Q000032:analysis; D001854:Bone Marrow Cells / Q000276:immunology / Q000473:pathology; D019070:Cell Lineage; D003430:Cross-Sectional Studies; D003581:Cytodiagnosis / Q000379:methods; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping / Q000379:methods*; D007938:Leukemia / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology*; D015448:Leukemia, B-Cell / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D014416:Tunisia
chemical_list: D015703:Antigens, CD
keywords: Acute leukemia; Cytologie; Cytology; Immunophenotype; Immunophénotypage; Leucémie aiguë