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Abstract
B-CLPDs are a heterogeneous group of clonal (neoplastic) diseases that share the single characteristic of arising as the result of a somatic mutation(s)in a B-lymphocyte progenitor.Any site of the lymphatic system can be the primary site of origin of the disorder, including LNs,gut-associated lymphatic tissue,skin,or spleen.
The diagnosis and classification of lymphopoietic malignancies are extremely complex and have undergone
successive changes over the course of time. Recognition of the various disease entities is essential because of major implications for prognosis and patient management. The diagnosis of the BCLPDs requires use of multiple technologies including cell morphology, immunological markers and, in some cases, histopathology of the affected tissues and molecular and cytogenetic investigations. However, it has become evident that the overlapping morphologic and immunophenotypic features of various B-CLPDs can make diagnosis difficult.
Flow cytometric IPT studies are indispensable for the diagnosis of mature B-cell lymphoid neoplasms. It is considered to be an integral part of the diagnostic process pointing to the
correct classification of the individual diseases and to the choice
of the most suitable type of therapy through the identification of
phenotypically abnormal cells belonging to the B-cell lineage and recognition of phenotypes characteristic of separate disease entities.
The aim of this study was to perform a comprehensive flow cytometric immunophenotypic analysis of B-CLPDs with the use of an extended panel of MoAbs to provide data on the pattern of
expression of various immunological markers in different B CLPDs, trying to resolve the immunophenotypic overlap, hence, clarifying the role of immunophenotyping in the precise diagnosis of these disorders.
This study was conducted on eighty two newly diagnosed BCLPDs patients. They were subjected to complete history taking, clinical examination and abdominal ultrasonography for organomegaly and lymphadenopathy. Diagnostic workup for BCLPDs cases included: CBC, BM aspiration and trephine biopsy, flow cytometric IPT using an extended panel of MoAbs. In certain cases, additional diagnostic tools were performed to reach/confirm
the diagnosis i.e. FISH for the t(11;14) and t(14;18) and Cy D1 immunohistochemical staining on BM trephine biopsy. LN biopsy reports were obtained from patients’ records. Accordingly, patients were classified into: forty CLL, seven aCLL, eight B-PLL, six MCL, ten HCL, four HCL-V, three SLVL, two FL and two LPL patients.