The Differential Diagnosis Of Lymphoproliferative Disorders By Immunophenotypic Analysis With Flow Cytometry

ObjectiveThe study of peripheral blood (PB) and bone marrow (BM) flow cytometric immunophenotyping (FCIP) in the diagnosis and differentiated diagnosis of chronic lymphoproliferative disorders(CLPD).MethodsThe immunophenotyes of 77 CLPD patients was studied by two/three-color multiparameter flow cytometry using a panel of monoclonal antibodies from January 2005 to 2010 in henan cancer hospital.ResultsAmong the seventy-seven cases of CLPD, fifty were B-CLL, three were MCL, two were FL, eight were HCL, three were SMZL, three were LPL/WM, three were T-CLL,three were T-LGL, one was NK-LGL and CNKL. Most of the CLPD studied were low grade,with chronic lymphocytic leukemia (CLL) being most common.The findings of these studies have often been extrapolated with the infere nce that the described immunophenotypes are diagnostic of the corresponding disease entity.For instance, CD5 and CD23 coexpression by a BCLPD is often considered diagnostic of chronic lymphocytic leukemia (CLL), and the absence of CD23 in a CD5+ BCLPD is typically thought of as de facto evidence of mantle cell lymphoma (MCL). Likewise, CD 10 positivity is considered to favo r strongly a diagnosis of follicular lymphoma (FL); CD25, dual CD11c/CD22, and CD 103 have all been touted as being "diagnostic" markers of hairy cell le ukemia (HCL);CD3+,CD56-,CD57+ and CD3-,CD56+,CD57-were the primary i mmunophenotype of T-LGL and NK.-LGL or CNKL.In addition, the immunoph enotype of SMZL and LPL/WM are variable and overlaps with other CLPD. Using these FCIP parameters and strict immunophenotypic definitions we obtai ned greater than 95% specificity for each diagnosis. However, we encountered the following exceptions to standard paradigms of B-CLPD-associated FCIP:(1) lack of uniform CD5 positivity in some CLL cases, (2) the immunophenotype of SMZL and LPL/WM are variable and overlaps with other CLPD.ConclusionPeripheral blood (PB) and bone marrow (BM) flow cytometric immunophe notyping (FCIP) is very important for the diagnosis,classification and progno sis of CLPD.It is an assistant but necessary approach for the diagnosis and dif ferentiated diagnosis of CLPD.