Clinical Oncology and Research | 2021
Flow Cytometry Analysis of Recurrent or Persistent Lymphadenopathy in Patients with Nodular Lymphocyte-Predominant Hodgkin Lymphoma
Abstract
Objectives: We recently examined the utility of flow cytometric analysis in the diagnosis of nodular \nlymphocyte predominant Hodgkin lymphoma (NLPHL) by examining reactive T-cell features. This study \naims to compare these features in sequential biopsies of persistent or recurrent lymphadenopathy in patients \nwith NLPHL.\nMethods: We reanalysed the histopathology and flow cytometry findings of 9 patients with multiple \nbiopsies for persistent or recurrent lymphadenopathy and either initial or recurrent NLPHL. A flow \ncytometry signature was considered suggestive of NLPHL if ≥12% of T-cells expressed CD57 or ≥3% of \nT-cells co-expressed CD4 and CD8.\nResults: A flow cytometry signature considered suggestive of NLPHL was seen in 18 of 20 specimens. \nBased on histopathology, 11 were diagnosed as NLPHL, 3 were initially underdiagnosed as atypical \nlymphoid proliferation, and 4 were initially incorrectly diagnosed as negative or progressive transformation \nof germinal centers. Flow cytometry showed similar expression patterns of CD57 and CD4/CD8 in T-cells \nbetween initial and subsequent biopsies. The remaining 2 specimens lacked the flow cytometry signature \nsuggestive of NLPHL and were histopathologically diagnosed as reactive hyperplasia.\nConclusion: Flow cytometry analysis based on our criteria is highly sensitive in detecting NLPHL. \nCorrelation with the cytospin cytology may increase the diagnostic specificity. A negative flow essentially \nruled out the possibility of NHLPHL.\n