Abstract
Introduction: Mature B cell neoplasms comprise over 90% of lymphoid neoplasms worldwide and 4% new cancers every year. Together with morphology, flow cytometry immunophenotyping is essential for the diagnosis of these diseases. Aim of the Study: The aim of this study was to examine concordance of working diagnosis with immunophenotyping results in patients with suspicion on mature B cell neoplasm. Patients and Methods: The examination included 125 patients, divided in 3 groups on diagnosis founded by haematologist: CLL, NHL and other (descriptive diagnosis). Sample was K2EDTA peripheral blood, diluted with phosphate buffer and incubated with appropriate combination of fluorochrome conjugated monoclonal antibodies .4-color antibody panel for B chronic lymphoproliferation was applied. Analysis performed on FACS Canto II flow cytometer, DIVA software. Results: In the first 2 groups, 72.9% immunophenotypization were in concordance with working diagnosis. 19.8% would have been misclassified without immunophenotypization, 7.3% were recommended for the further examination. In the group 'other', diagnosis couldn't have been established without immunophenotypization. 12 samples were not chronic B lymphoproliferative diseases, and 8 had normal B cell immunophenotype. Conclusion: In some patients, clinical features and cell morphology are not specific for the disease and thus insufficient for the diagnostic conclusion. By using flow cytometry, misclassification and inadequate therapy was prevented for significant number of patients and diagnosis established for those with descriptive diagnosis. Panel for chronic lymphoproliferative diseases is also useful for differential diagnostic exclusion of chronic lymphoproliferative disease and pointing towards specified direction, e.g. acute leucosis, T, B, NK lymphoproliferative disorders or to confirm normal B cell phenotype.
Highlights
Mature B cell neoplasms comprise over 90% of lymphoid neoplasms worldwide and 4% new cancers every year
Misclassification and inadequate therapy was prevented for significant number of patients and diagnosis established for those with descriptive diagnosis
Panel for chronic lymphoproliferative diseases is useful for differential diagnostic exclusion of chronic lymphoproliferative disease and pointing towards specified direction, e.g. acute leucosis, T, B, NK lymphoproliferative disorders or to confirm normal B cell phenotype
Summary
Mature B cell neoplasms comprise over 90% of lymphoid neoplasms worldwide and 4% new cancers every year. The extreme complexity of these diseases on one side, and availability of the different therapeutic protocols for the different types of these diseases on the other side, made the accurate and precise diagnosing the imperative Contribution to this is made by the fact that the World Health Organization in the Classification of Tumours of Haemopoietic and Lymphoid Tissues suggests multiparametric approach in diagnosis of these diseases, and basic parameter, besides the detailed history of the disease and the clinical examination, are morphological, immunophenotypic and genetic research for each entity of the disease.[1] The clinical picture and cell morphology itself, as well known and applied means of research, are insufficient in many cases, quite often due to the similar clinical presentation and cell morphology, it is not possible to draw a diagnostic conclusion based on these finding or, in some cases, it results to be wrong diagnosis. In the cases of the atypical phenotype, the disease is assigned to the appropriate group and additional examinations should be done due to the precise diagnostics (immunohistochemical, FISH, molecular researches)
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