Lymphoid and myeloid neoplasms involving cerebrospinal fluid: comparison of morphologic examination and immunophenotyping by flow cytometry (original) (raw)
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Flow Cytometric Immunophenotyping of Cerebrospinal Fluid Specimens
American Journal of Clinical Pathology, 2011
Flow cytometric immunophenotyping (FCI) is recommended in the evaluation of cerebrospinal fluid (CSF) specimens for hematologic neoplasms. This study reviewed FCI of CSF specimens collected for primary diagnosis (n = 77) and follow-up for known malignancy (n = 153). FCI was positive in 11 (4.8%) of 230 specimens: acute myeloid leukemia, 6; precursor B-acute lymphoblastic leukemia, 2; B-cell lymphoma, 2; and T-cell lymphoma, 1. Positive results were obtained in low-cellularity specimens, including 2 with fewer than 100 events in the population of interest. FCI was indeterminate in 19 (8.3%) of 230 specimens, including 3 with only sparse events, 8 with possible artifact (apparent lack of staining, nonspecific or background staining, and aspirated air), and 8 with phenotypic findings considered insufficient for diagnosis. Indeterminate specimens were often limited by low cellularity and lacked normal cell populations to evaluate for appropriate staining. FCI may be of value in low-cellularity CSF specimens, although the results should be interpreted with caution.
Annals of Hematology, 2011
An independent clinical assessment was compared with flow cytometry (FCM) and cytomorphology results obtained on 227 cerebrospinal fluids investigated for hematologic malignancy, in a retrospective longitudinal study with a median observation time of 11 months. A combined method assessment (CMA), defining 'positive' a sample if at least one method gave 'positive' results, was also tested. Eleven out of 55 screening samples and 53 out of 166 follow-up samples resulted positive at clinical evaluation. FCM and CM were concordant with positive clinical assessment in 68.5% and 51.5% of cases,
Cancer, 2006
BACKGROUND. Involvement of the cerebrospinal fluid (CSF) by hematopoietic malignancies may be difficult to document by morphology alone. In cases with low numbers of cells or ambiguous morphology, the diagnoses of "atypical" or "suspicious" may be used. The significance of these diagnostic terms in this scenario has not been well established. METHODS. Between January 2000 and July 2004, 32 patients with known lymphoma or leukemia and an initial diagnosis of "atypical" or "suspicious" using morphologic criteria were identified. Subsequent flow cytometry (FC) and cytologic data from these patients were evaluated. RESULTS. Of the 32 patients with an initial diagnosis of "atypical" or "suspicious," 40.6% (n ϭ 13) had negative first and subsequent FC and morphologic evaluation of their CSF samples with follow-up up to 1 year. Nineteen patients (59.4%) had malignant hematopoietic cells identified in subsequent CSF samples by cytology and/or FC. CONCLUSIONS. In patients with a previous history of lymphoma or a hematopoietic malignancy, a majority of the patients (59.4%) with an "atypical" or "suspicious" diagnosis on CSF will ultimately have malignant cells identified in the CSF by cytology and/or FC. Many of these patients can be identified more expediently with the concurrent utilization of flow cytometry. Cancer (Cancer Cytopathol)
FACS analysis—a new and accurate tool in the diagnosis of lymphoma in the cerebrospinal fluid
Clinica Chimica Acta, 2002
Background: Fluorescence activated cell scanning (FACS) is a useful tool for identifying malignant cell clones of lymphoma cells in cerebrospinal fluid (CSF) by immunological phenotype. Methods: We used FACS analysis for demonstrating it to be a quick and reliable technology that is available in most hematological laboratories. In this study, we demonstrate the clinical application of FACS analysis within a series of 15 lymphoma patients with suspected CSF involvement. CSF from three patients with another diagnosis than lymphoma serves as negative control. Results and conclusion: A malignant cell clone cannot only be identified in CSF phenotypically, but also classified according to the immunological surface profile. As this method improves the diagnostic sensitivity and specificity, it should be implemented into routine diagnosis. D 0009-8981/02/$ -see front matter D 2002 Elsevier Science B.V. All rights reserved. PII: S 0 0 0 9 -8 9 8 1 ( 0 1 ) 0 0 7 7 1 -9
Cerebrospinal fluid cytological and biochemical characteristics in the presence of CNS neoplasia
Arquivos de Neuro-Psiquiatria, 2007
Central nervous system (CNS) infiltration must be ruled out in patients with known neoplastic diseases and neurological symptoms. It was done a retrospective analysis of 1,948 CSF samples from patients with suspected malignant infiltration in the CNS, in order to evaluate the positivity rate of malignant cells in cerebrospinal fluid (CSF) samples and correlate with cytochemical characteristics. Sixty-two percent of subjects had acute lymphocytic leukemia. Malignant cells were found in 24% of all CSF samples. Subjects with positive malignant cells had predominance of increased levels of CSF total protein (TP), glucose and total cytology (p<0.05). Mean total cell count in this group was 232 (SD 933) cells/mm³, compared to 9 (SD 93) cells/mm³ in the group without neoplasic cells (p=0.029). CSF TP specificity was 87% and negative predictive value (NPV) 96%. CSF total cell count specificity 86% and NPV 97%. Although sensitivity and positive predictive value were low. The presence of i...
Universitas Scientiarum
Central nervous system infiltration by acute leukemia is a poor prognosis variable, and conventional cytology is the gold standard for its diagnosis; the technique is highly specific but not sensitive. To improve the diagnosis, flow cytometry has been used in different studies, showing greater sensitivity in the detection of leukemic cells. This study aimed to evaluate the presence of tumor cells by flowcytometry and conventional cytology, in cerebrospinal fluid from patients with acute leukemia as well as its relationship with clinical and biological parameters. In total, 156 CSF samples from 55 children with acute leukemia were studied. We found the following results: FCM-/CC- 131/156; FCM+/CC- 19/156; FCM-/CC+ 0; FCM+/CC+ 1/156; FC-/CC suspicious 1/156; and FCM+/CC suspicious 4/156. Patients with B-cell acute lymphoblastic leukemia and FCM+ showed a lower response to steroid-treatment, abnormal karyotype, neurological symptoms, and worse relapsefree survival. Patients with T-cell...
Cytology of primary central nervous system neoplasms in cerebrospinal fluid specimens
Diagnostic Cytopathology, 2002
Although two-thirds of tumors occurring in the central nervous system (CNS) are primary neoplasms, only 10% of positive cerebrospinal fluid (CSF) specimens are from primary CNS tumors. In this study, we reviewed the cytologic findings of 21 positive CSF specimens from primary CNS tumors. A computer search identified 21 cases of positive CSF specimens from patients with primary CNS tumors from the archives. Follow-up included review of medical charts and histologic correlation. The specimens were from 20 patients (9 females and 11 males). Their ages ranged from 6 -83 yr, old with a mean of 30 yr. The cases included 9 medulloblastomas, 7 gliomas (3 glioblastoma multiformes, 2 anaplastic astrocytomas, and 2 ependymomas), 2 germinomas, 2 non-Hodgkin's large B-cell lymphomas, and 1 ganglioneurocytoma. Two cases were classified as suspicious and the remaining as positive for malignancy. Immunocytochemistry was employed in 3 cases to support the cytologic diagnosis. These cases included one large-cell lymphoma (leukocyte-common antigen-positive), one germinoma (placental alkaline phosphatase-positive), and the ganglioneurocytoma (neuron-specific enolase-and synaptophysinpositive). There were no false-positive cases. Our results suggest that positive CSF cytology in patients with a primary CNS tumor is a reliable indicator of malignancy and reflects leptomeningeal involvement. The use of immunocytochemistry is helpful in confirming the cytologic impression in some cases. Diagn. Cytopathol. 2002;26:209 -212.
American Journal of Clinical Pathology, 2002
Anatomic Pathology / ORIGINAL ARTICLE Am J Clin Pathol 2002;117:952-958 953 © American Society for Clinical Pathology by guest on February 2, 2016 http://ajcp.oxfordjournals.org/ Downloaded from Anatomic Pathology / ORIGINAL ARTICLE Am J Clin Pathol 2002;117:952-958 955 * Data are given as number (percentage) of events based on the number of CD45 events. In cases 7 and 9, the neutrophils were the main population. † Data are given as number (percentage) of events based on the total CD3+ lymphocytes. ‡ B cells in cases 4, 5, 6, and 10 coexpressed CD10 among their surface antigens. by guest on February 2, 2016 http://ajcp.oxfordjournals.org/ Downloaded from Anatomic Pathology / ORIGINAL ARTICLE Am J Clin Pathol 2002;117:952-958 957