Lymphoma is a common malignancy worldwide affecting both children and adults. In Bangladesh, non-Hodgkin lymphoma (NHL) is relatively common and contributing to 7% of total cancer reported 1 as compared to 4% in USA. 2 Nodal lymphoma is rather prevalent in Bangladesh; for instance, lymphoma constitutes about 6% of all the cases of cervical lymphadenopathy persisting for more than three weeks. 3 Although fine needle aspiration cytology can diagnose almost all the cases of reactive lymphadenitis, only up to about 86% cases of NHL can be correctly identified by cytology alone. 4Fine needle aspiration cytology is accepted in recurrence lymphoma; primary diagnosis and classification of NHLs are usually made by histological examination and till date, considered to be the gold standard. Worldwide, many centers have reported fine needle aspiration cytology show relatively high sensitivity and specificity in the diagnosis of lymphomas when used in conjunction with other ancillary techniques in last 15 years. 5, 6 Despite this, nonHodgkin lymphoma diagnosis of on fine needle aspiration material has remained controversial. 7-9 Even though architectural and morphologic feature continues to be important parameters in World Health Organization's classifycation of hematopoietic and lymphoid tumors, lymphoma diagnosis is now routinely based on combined information from clinical manifestations, histomorphologic features, immunophenotype and genotype. 10, 11, 12 Flow cytometric immunophenotyping offers many advantages in the analysis of fine needle aspiration materials for lymphoma diagnosis. Moreover, it requires small number of cells and is also suitable for cells already in suspension. It is very sensitive immunophenotyping technique, and can detect aberrant cells even 1/10,000 cells. 13 Thus, it almost replaced the classic immunocytochemistry. 14 As in immunocytochemistry only one antigen can be assessed per cell at a time, it is rather time consuming. Large number of specific monoclonal anti-bodies combining four or more fluorochromes can precisely define the cell profile and neoplastic nature of lymphoid cells make FCI is a more sensitive, specific and swift diagnostic tool than is immunocytochemistry. 13, 15-17Indeed FCI evaluates several antigens on one cell (including cytoplasmic antigens), and can | Original | Article |
AbstractThe purpose of the present study was to compare the routine cytology, histology, immunohistochemistry and flow cytometry in the diagnosis of nodal lymphoma cases. Thirty five cases of clinically suspected lymphoproliferative disorder were included in this study. After preparation of smears from the fine needle aspirates on the glass slides for cytology, the residual material was processed for flow cytometric immunophenotyping accordingly. Subsequently, histopathology and immunohistochemistry findings of selected cases of lymph node biopsy were correlated to confirm and compare the diagnosis. Flow cytometric immunophenotypes of most of the cases corresponded to the histological and immunohistochem...