TY - JOUR
T1 - Flow cytometric analysis of fine needle aspirates is affected by tumor subtype, but not by anatomic location nor technique
AU - Wake, Laura M.
AU - VandenBussche, Christopher J.
AU - Ali, Syed Z.
AU - Wagner-Johnston, Nina D.
AU - Burns, Kathleen H.
AU - Gocke, Christopher D.
AU - Vuica-Ross, Milena
AU - Borowitz, Michael J.
AU - Duffield, Amy S.
N1 - Funding Information:
The authors thank Dr. Cordelia Sever for information regarding the preliminary findings of the committee established to draft the ASCP/CAP/ASH Laboratory Workup of Lymphoma Guidelines. The preliminary guidelines were presented at the 2019 ASCP Annual Meeting (Phoenix, AZ). This study was supported in part by the Sidney Kimmel Comprehensive Cancer Center Grant from the National Institutes of Health (P30 CA006973; N.D.W.‐J., K.H.B., C.D.G., M.J.B., A.S.D.).
Publisher Copyright:
© 2020 Wiley Periodicals, Inc.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Background: Current clinical practices are shifting towards utilizing less invasive biopsy techniques, including fine needle aspiration (FNA) and needle core biopsies. If a patient has a suspected hematologic malignancy, a portion of the FNA sample is typically submitted for flow cytometry (FC) analysis, providing valuable immunophenotypic data. Methods: FNA specimens were identified via a pathology database search. All cases were morphologic evaluated and a subset of cases were analyzed by FC. Results: 245 hematologic FNA specimens were identified; 84% of these cases had an adequate number of cells for FC analysis, and an unequivocal morphologic diagnosis (benign or malignant) was rendered in 85%. The percentage of cases with an unequivocal diagnosis was statistically significantly higher in those with associated FC than with those without FC (90% vs 58%). Neither FNA technique nor anatomic site affected the likelihood of obtaining an adequate sample for FC analysis and/or rendering a definitive morphologic or unequivocal FC diagnosis. Likewise, tumor subtype did not affect the likelihood of acquiring enough cells for FC analysis, but occasionally resulted in equivocal FC diagnoses or discordant FNA and FC diagnoses. Aggressive B-cell lymphomas and Hodgkin lymphomas were significantly less likely to be detected by FC as compared to low-grade B-cell lymphomas. Discrepancies between FNA and FC diagnoses occurred in 13% of cases. The majority of discrepancies (78%) included FC false negatives, while only 22% of cases had atypical or positive FC with negative FNA. Conclusions: FNA with associated FC is a powerful diagnostic technique; however, lymphoma subtype may affect diagnostic sensitivity by FC, and therefore, discordant FNA and FC results should be interpreted with caution.
AB - Background: Current clinical practices are shifting towards utilizing less invasive biopsy techniques, including fine needle aspiration (FNA) and needle core biopsies. If a patient has a suspected hematologic malignancy, a portion of the FNA sample is typically submitted for flow cytometry (FC) analysis, providing valuable immunophenotypic data. Methods: FNA specimens were identified via a pathology database search. All cases were morphologic evaluated and a subset of cases were analyzed by FC. Results: 245 hematologic FNA specimens were identified; 84% of these cases had an adequate number of cells for FC analysis, and an unequivocal morphologic diagnosis (benign or malignant) was rendered in 85%. The percentage of cases with an unequivocal diagnosis was statistically significantly higher in those with associated FC than with those without FC (90% vs 58%). Neither FNA technique nor anatomic site affected the likelihood of obtaining an adequate sample for FC analysis and/or rendering a definitive morphologic or unequivocal FC diagnosis. Likewise, tumor subtype did not affect the likelihood of acquiring enough cells for FC analysis, but occasionally resulted in equivocal FC diagnoses or discordant FNA and FC diagnoses. Aggressive B-cell lymphomas and Hodgkin lymphomas were significantly less likely to be detected by FC as compared to low-grade B-cell lymphomas. Discrepancies between FNA and FC diagnoses occurred in 13% of cases. The majority of discrepancies (78%) included FC false negatives, while only 22% of cases had atypical or positive FC with negative FNA. Conclusions: FNA with associated FC is a powerful diagnostic technique; however, lymphoma subtype may affect diagnostic sensitivity by FC, and therefore, discordant FNA and FC results should be interpreted with caution.
KW - FNA
KW - fine needle aspirates
KW - flow cytometry
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U2 - 10.1002/dc.24417
DO - 10.1002/dc.24417
M3 - Article
C2 - 32212260
AN - SCOPUS:85082196982
SN - 8755-1039
VL - 48
SP - 538
EP - 546
JO - Diagnostic cytopathology
JF - Diagnostic cytopathology
IS - 6
ER -