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Abstract

BackgroundAn elevated CD4/CD8 T-cell ratio on flow cytometry (FCM) analysis has been reported in the literature to be associated with Hodgkin lymphoma (HL). The purpose of our study was to determine the diagnostic significance of an elevated CD4/CD8 ratio in lymph node fine needle aspiration (FNA) specimens.DesignBetween 1996 and 2002, out of 837 lymph node FNAs submitted for flow cytometry analysis, 85 cases showed an elevated CD4/CD8 ratio, defined as greater than or equal to 4, without definitive evidence of a lymphoproliferative disorder. The cytologic diagnoses of these 85 cases were grouped into four categories: reactive, atypical, Hodgkin lymphoma (HL), and non-Hodgkin lymphoma (NHL). Histologic follow-up was available in 17/85 (20%) of the cases.Results5 of the 64 cases in which FCM and cytology did not reveal evidence of a lymphoproliferative disease had tissue follow-up because of persistent lymphadenopathy and high clinical suspicion. 3/5 (60%) confirmed the diagnosis of reactive lymphadenopathy. The two remaining cases (40%) were positive for lymphoma (1HL, 1NHL). 8/15 cases called atypical on cytology had histologic follow-up. 7/8 (87.5%) cases were positive for lymphoma (3HL, 4NHL). 3/4 cases called HL on cytology had tissue follow-up and all 3 (100%) confirmed the diagnosis of HL. One case diagnosed as NHL on cytology was found to be a diffuse large B-cell lymphoma. In summary, out of 17 cases with histologic follow-up 4/17 (24%) were reactive with CD4/CD8 T-cell ratio of 4.1–29, 7/17 (41%) were HLs with CD4/CD8 T-cell ratio of 5.3 – 11, and 6/17 (35%) were NHLs with CD4/CD8 T-cell ratio of 4.2 – 14.ConclusionAn elevated CD4/CD8 ratio on FCM is a nonspecific finding which may be seen in both reactive and lymphoproliferative disorders. The cytomorphologic features of the smear are more relevant than the sole flow cytometric finding of an elevated CD4/CD8 ratio.

The Impact of Past COVID-19 Infection on Selected Lymphocyte Subsets in Pediatric Patients

“…Surprisingly, the CD4 + /CD8 + index is relevantly higher in patients than in controls. Similar findings are observed in patients with sarcoidosis [ 27 ] and in lymphoproliferative diseases [ 28 ]. High index is also proposed to be a marker of poor outcome of adult COVID-19 patients [ 29 , 30 ].…”

Testicular activin and follistatin levels are elevated during the course of experimental autoimmune epididymo–orchitis in mice

“…The data were supported by a higher ratio of CD4+/CD8+ T cells in the testis, which is comparable to many other immune disorders and diseases. In fact, this ratio can also be used as a diagnostic tool for several inflammatory diseases like infectious mononucleosis, chronic lymphocytic leukaemia, Hodgkin disease, anaemia or autoimmune neurological disorder like multiple sclerosis 44 45 . In alignment with our data, the evidence for a requirement for the CD4+, but not CD8+ T cell subset for the development of murine EAEO was shown in adoptive transfer experiments 46 .…”

Estimating genetic and phenotypic parameters of cellular immune-associated traits in dairy cows

“…In humans, the CD4 + :CD8 + ratio can be used as a marker of human immunodeficiency virus to acquired immunodeficiency syndrome progression (Fahey et al, 1990;Serrano-Villar et al, 2015). Other human health conditions that have been previously associated with the CD4 + :CD8 + ratio include chronic lymphocytic leukemia (Bartik et al, 1998;Gonzalez-Rodriguez et al, 2010), infectious mononucleosis and other viral infections (Karcheva et al, 2008;Salih, 2009), Hodgkin disease (Gupta, 1980;Poppema, 1996;Gorczyca et al, 2002;Hernandez et al, 2005), aplastic anemia (Zhang et al, 2007), as well as neurological disorders such as multiple sclerosis (Pender et al, 2014) and myasthenia gravis (Berrih et al, 1981;Matsui and Kameyama, 1986). Further, substantial evidence exists that this trait is under genetic control in mice, chickens, and humans (Kraal et al, 1983;Clementi et al, 1999;Amadori et al, 1995;Myrick et al, 2002;Ewald et al, 1996).…”