Title: Body cavity fluid flowcytometry in the diagnosis of haematolymphoid neoplasms
Authors: Dr Priya Mary Jacob, MD, Dr Rekha. A.Nair, MD, Dr Jayasudha. A.V, MD, Dr Nileena Nayak, MD, Dr Renu Sukumaran, MD, Dr Sreejith. G. Nair, MD, DM. , Dr Sumod Mathew Koshy MD, FRCR
DOI: https://dx.doi.org/10.18535/jmscr/v6i9.75
Abstract
Introduction: Flow cytometry provides a rapid and accurate analysis of haematopoetic tumour cells in serous fluids.
Material & Methods: This is a study of body cavity fluids in which flow cytometry was used to characterize the haematopoetic cells. Period of study is from January 2012 to May 2018.
Results: 39 patients were included in the study, out of which, there were 8ascitic fluid, 2 CSF (cerebrospinal fluid) and 29 pleural fluid samples. Among the asciticfluid samples, most common cases were of Burkitt lymphoma. In the 2 CSF cases, one was a rare case of leptomeningeal Diffuse Large B cell lymphoma and the other was a reactive lymphoid population. Among the pleural fluids, most common was T- Lymphoblastic Lymphoma. Among the pleural fluid samples there were 4 reactive lymphocytosis (3 associated with Classical Hodgkin Lymphoma & 1 with a Primary Mediastinal Large B cell Lymphoma). The 3 benign effusions associated with Classical Hodgkin Lymphoma showed an abnormal increased CD4:CD8 ratio.
In addition to flow cytometry, in cases of DLBCL/ Burkitt lymphoma IHC markers like bcl2, bcl6, SIgM, TdT and MIB were done on cell block preparation to corroborate the diagnosis.
Conclusion: Flow cytometry helps rapidly and accurately characterize benign and malignant haematolymphoid effusions and in conjugation with immunohistochemistry on cell block preparation obviates the need for a tissue biopsy .The increased CD4 T cell subset in pleural fluid samples of Classical Hodgkin Lymphoma probably corresponds to the increase in T regulatory cells with a CD4, CD25, CD152, and FoxP3 immunophenotype which has been identified in the background T cell population of Classical Hodgkin Lymphoma.
Keywords: Body fluid, flow cytometry.
