title: Diagnostic Utility of Flow Cytometry Analysis of Reactive T Cells in Nodular Lymphocyte-Predominant Hodgkin Lymphoma.
abstract: OBJECTIVE
  This study aims to define the diagnostic utility of flow cytometric features of T cells in nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL).
  
  
  METHODS
  Cases were retrospectively identified based on diagnosis with NLPHL (n = 30 samples), classic Hodgkin lymphoma (CHL; n = 33), and reactive lymphoid hyperplasia (RLH; n = 43). Pathology slides were reviewed. Flow cytometry list mode data were reanalyzed.
  
  
  RESULTS
  The mean proportion of CD4 + CD8 + T cells (8.4%) in cases of NLPHL was significantly higher than seen in CHL (1.0%) or RLH (0.6%). Of the T cells, 28.4% were CD57 + in NLPHL, significantly higher (P < .05) than in CHL (3.2%) or RLH (3.2%). Based on receiver operating characteristic curve analysis, when using a cutoff of 3.0% of CD4 + CD8 + T cells, the diagnostic sensitivity for NLPHL is 83.3% with a specificity of 97.4%. The diagnostic sensitivity was 96.7% with a specificity of 98.7% when using a cutoff of 12% for CD57 + T cells.
  
  
  CONCLUSIONS
  Increased portions of CD57 + T cells and CD4 + CD8 + T cells are highly suggestive of the possibility of NLPHL. In addition, NLPHL diagnosis appears unlikely if neither CD57 + T cells nor CD4 + CD8 + T cells are increased. Future prospective studies including cases of progressive transformation of germinal center and T-cell/histiocyte-rich large B-cell lymphoma will further define the utility of flow cytometry of T cells in NLPHL.
authors.affiliation: From the Department of Pathology, Oakland University William Beaumont School of Medicine, Rochester, MI;
authors.forename: James A
authors.initials: JA
authors.lastname: David
authors.affiliation: From the Department of Pathology, Oakland University William Beaumont School of Medicine, Rochester, MI; Department of Clinical Pathology, William Beaumont Hospital, Royal Oak, MI. james.huang@beaumont.edu.
authors.forename: James Z
authors.initials: JZ
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005434:Flow Cytometry; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013601:T-Lymphocytes / Q000276:immunology* / Q000473:pathology; D055815:Young Adult
keywords: CD4:CD8 ratio; CD57; Flow cytometry; Hematopathology; Immunopathology; NLPHL; Nodular lymphocyte-predominant Hodgkin lymphoma; T-cell immunophenotype