Large cell lymphoma (LCL) is routinely detected by cytology. Flow cytometry (FC) allows immunophenotyping and staging. Acute leukemia (AL) cells can infiltrate lymph nodes (LN) and cytologic diagnosis is challenging. Here we describe immunophenotypic and hematologic features of AL infiltrating LN. Fourteen AL diagnosed as LCL by cytology were investigated. FC of LN, bone marrow (BM) and peripheral blood (PB) was performed using antibodies directed to lymphoid, myeloid and precursor markers. Diagnosis was based on immunophenotype and BM infiltration with >20% of AL cells. All dogs were purebred except 2; 6 were Golden Retrievers. Age ranged from one to 11 years (median = 6). FC classified leukemias as myeloid (AML, n = 8), lymphoid (B-ALL, n = 3) and undifferentiated (AUL, n = 3). Scatter properties showed medium-sized cells in AML and AUL, and large cells in B-ALL (resembling those of LCL). All cases were CD45 + dim and CD34 + or +/-; 7 cases were CD117 + . Four AML were CD14 + /- suggesting a monocytic differentiation. Seven dogs had leukocytosis (16000–572000/ uL) and 6 were leukopenic (420–5100/uL). All cases presented nonregenerative anemia and thrombocytopenia except one and 2, respectively. BM infiltration was always obvious both at cytology and FC, while PB involvement was variable (0–98%). Cytology can lead to misdiagnosis of lymphoma in AL cases. FC on LN allows an easy identification of myeloid cells and a diagnosis of AML. CBC should always be done in case of suspected lymphoma, because it can reveal an overt leukemia. However, a very low or undetectable infiltration of PB is possible. BM evaluation is always diagnostic and it is mandatory to differentiate between lymphoma and ALL.
Flow cytometry is useful to detect cytological misdiagnosis of canine large cell lymphoma
RIONDATO, Fulvio;POGGI, ALESSIA;MINISCALCO, Barbara
2014-01-01
Abstract
Large cell lymphoma (LCL) is routinely detected by cytology. Flow cytometry (FC) allows immunophenotyping and staging. Acute leukemia (AL) cells can infiltrate lymph nodes (LN) and cytologic diagnosis is challenging. Here we describe immunophenotypic and hematologic features of AL infiltrating LN. Fourteen AL diagnosed as LCL by cytology were investigated. FC of LN, bone marrow (BM) and peripheral blood (PB) was performed using antibodies directed to lymphoid, myeloid and precursor markers. Diagnosis was based on immunophenotype and BM infiltration with >20% of AL cells. All dogs were purebred except 2; 6 were Golden Retrievers. Age ranged from one to 11 years (median = 6). FC classified leukemias as myeloid (AML, n = 8), lymphoid (B-ALL, n = 3) and undifferentiated (AUL, n = 3). Scatter properties showed medium-sized cells in AML and AUL, and large cells in B-ALL (resembling those of LCL). All cases were CD45 + dim and CD34 + or +/-; 7 cases were CD117 + . Four AML were CD14 + /- suggesting a monocytic differentiation. Seven dogs had leukocytosis (16000–572000/ uL) and 6 were leukopenic (420–5100/uL). All cases presented nonregenerative anemia and thrombocytopenia except one and 2, respectively. BM infiltration was always obvious both at cytology and FC, while PB involvement was variable (0–98%). Cytology can lead to misdiagnosis of lymphoma in AL cases. FC on LN allows an easy identification of myeloid cells and a diagnosis of AML. CBC should always be done in case of suspected lymphoma, because it can reveal an overt leukemia. However, a very low or undetectable infiltration of PB is possible. BM evaluation is always diagnostic and it is mandatory to differentiate between lymphoma and ALL.
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