title: The utility of multiparametric seven-color flow cytometry in the detection of double hit lymphoma in ascitic fluid samples.
abstract: Double-hit lymphoma (DHL) is a rare type of lymphoma with concurrent chromosomal translocations of C-MYC with BCL2 or BCL6, associated with unfavorable prognosis. We describe a case of DHL in a 79-year-old female patient previously diagnosed with diffuse large B-cell lymphoma (DLBCL) with an early relapse in the ascitic fluid. A seven-color multiparametric flow cytometry immunophenotyping study of the ascitic fluid was carried out, and revealed 99.78% of large in size and high cellular complexity B-cells positive for CD19, CD10 (64.27%), CD45 dim, CD22 dim, CD25 (60%), CD43 bright, CD38 bright, and IgM (18.53%); and negative for CD20, CD5, CD23, CD79b, CD103, CD200, CD11c, and FMC7, and 78.99% without light chain expression and 21% with Lambda chain restriction. Due to the expression of CD19 and CD10 with overexpression of BCL-2 protein and due to CD43 and CD38 positivity detected, those cells showed features between DLBCL and Burkitt lymphoma. Fluorescence in situ hybridization (FISH) confirmed both c-MYC/IGH and BCL2/IGH rearrangement. Our findings may help to identify cases requiring additional cytogenetic analysis. © 2015 International Clinical Cytometry Society.
authors.affiliation: Lymphoma Unit, Hematology Deparment, Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain.
authors.forename: Raul
authors.initials: R
authors.lastname: Cordoba
authors.affiliation: Central Laboratory, Flow Cytometry Unit, Infanta Sofia University Hospital, San Sebastian De Los Reyes, Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Alvarez
authors.affiliation: Hematology Department, Infanta Sofía University Hospital, San Sebastian De Los Reyes, Madrid, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Masso
authors.affiliation: Central Laboratory, Hematology Unit, Infanta Sofia University Hospital, San Sebastian De Los Reyes, Madrid, Spain.
authors.forename: Fernando Ataulfo
authors.initials: FA
authors.lastname: Gonzalez
authors.affiliation: Central Laboratory, Flow Cytometry Unit, Infanta Sofia University Hospital, San Sebastian De Los Reyes, Madrid, Spain.
authors.forename: Luz
authors.initials: L
authors.lastname: Conejo
authors.affiliation: Central Laboratory, Hematology Unit, Infanta Sofia University Hospital, San Sebastian De Los Reyes, Madrid, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Velasco
authors.affiliation: Central Laboratory, Hematology Unit, Infanta Sofia University Hospital, San Sebastian De Los Reyes, Madrid, Spain.
authors.forename: Juan-Manuel
authors.initials: JM
authors.lastname: Alonso
authors.affiliation: Central Laboratory, Hematology Unit, Infanta Sofia University Hospital, San Sebastian De Los Reyes, Madrid, Spain.
authors.forename: Jesus
authors.initials: J
authors.lastname: Villarrubia
authors.affiliation: Central Laboratory, Hematology Unit, Infanta Sofia University Hospital, San Sebastian De Los Reyes, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Cava
authors.affiliation: Lymphoma Unit, Hematology Deparment, Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Llamas
mesh_terms: D000368:Aged; D001202:Ascitic Fluid / Q000473:pathology*; D002051:Burkitt Lymphoma / Q000175:diagnosis / Q000473:pathology; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D006801:Humans; D016130:Immunophenotyping / Q000379:methods; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000473:pathology*
keywords: double-hit; flow cytometry; lymphoma