Diagnostic Utility of Flow Cytometry Analysis of Reactive T Cells in Nodular Lymphocyte-Predominant Hodgkin Lymphoma June 17, 2016 About The Author James Huang, M.D. Oakland University William Beaumont School of Medicine, Rochester, MI, USA James Huang undertook his early medical studies at Hunan Medical University, Changsha, China, completing a research fellowship at Harvard Medical School, a pathology residency at Dartmouth-Hitchcock Medical Center, a hematopathology fellowship in University of Nebraska Medical Center. He is currently an Associate Professor of Pathology, Co-Director of Diagnostic Medicine Clerkship, and Director of Clinical Pathology Elective at Oakland University William Beaumont School of Medicine. He is also a senior staff hematopathologist at Beaumont Health. Dr. Huang is on the Editorial Board of a number of journals including International Journal of Pathology and Clinical Research, the Clinics in Oncology, and Pathology- Remedy Open Access. About The Author James David, M.D. Oakland University William Beaumont School of Medicine, Rochester, MI, USA James David graduated from Oakland University William Beaumont School of Medicine. This research was his capstone project for which he received a competitive scholarship award form Oakland University William Beaumont School of Medicine. He is currently in residency program in ophthalmology at Louisiana State University-Ochsner, Louisiana. Journal Reference Am J Clin Pathol. 2016 Jan;145(1):107-15. David JA1, Huang JZ2. Show Affiliations From the Department of Pathology, Oakland University William Beaumont School of Medicine, Rochester, MI; From the Department of Pathology, Oakland University William Beaumont School of Medicine, Rochester, MI; Department of Clinical Pathology, William Beaumont Hospital, Royal Oak, MI. [email protected] Abstract OBJECTIVES: 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. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: [email protected] Go To Am J Clin Pathol. 2016-06-17 GMD staff
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