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Morphology and multiparameter flow cytometry combined for integrated lymphoma diagnosis on small volume samples : possibilities and limitations

Ehinger, Mats LU and Béné, Marie C. (2024) In Virchows Archiv 485(4). p.591-604
Abstract

The diagnosis of lymphoma relies mainly on clinical examination and laboratory explorations. Among the latter, morphological and immunohistochemical analysis of a tissue biopsy are the cornerstones for proper identification and classification of the disease. In lymphoma with blood and/or bone marrow involvement, multiparameter flow cytometry is useful. This technique can also be applied to fresh cells released from a biopsy sample. For full comprehension of lymphomas, surgical biopsies are best and indeed recommended by the hematopathological community. Currently, however, there is a global trend towards less invasive procedures, resulting in smaller samples such as core needle biopsies or fine needle aspirations which can make the... (More)

The diagnosis of lymphoma relies mainly on clinical examination and laboratory explorations. Among the latter, morphological and immunohistochemical analysis of a tissue biopsy are the cornerstones for proper identification and classification of the disease. In lymphoma with blood and/or bone marrow involvement, multiparameter flow cytometry is useful. This technique can also be applied to fresh cells released from a biopsy sample. For full comprehension of lymphomas, surgical biopsies are best and indeed recommended by the hematopathological community. Currently, however, there is a global trend towards less invasive procedures, resulting in smaller samples such as core needle biopsies or fine needle aspirations which can make the diagnosis quite challenging. In this review, the possibilities and limitations to make an accurate lymphoma diagnosis on such small volume material are presented. After recalling the major steps of lymphoma diagnosis, the respective value of histology, cytology, and flow cytometry is discussed, including handling of small specimens. The benefits of an integrated approach are then evoked, followed by discussion about which attitude to adopt in different contexts. Perhaps contrary to the prevailing view among many pathologists, a full diagnosis on small volume material, combined with relevant ancillary techniques, is often possible and indeed supported by recent literature. A glimpse at future evolutions, notably the merit of artificial intelligence tools, is finally provided. All in all, this document aims at providing pathologists with an overview of diagnostic possibilities in lymphoma patients when confronted with small volume material such as core needle biopsies or fine needle aspirations.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Biopsy, Cytology, Diagnosis, Fine needle, Flow cytometry, Lymphoma
in
Virchows Archiv
volume
485
issue
4
pages
591 - 604
publisher
Springer
external identifiers
  • scopus:85194836589
  • pmid:38805049
ISSN
0945-6317
DOI
10.1007/s00428-024-03819-3
language
English
LU publication?
yes
id
3b2a20bd-bf64-48b3-b2cb-3956a6f24334
date added to LUP
2024-10-14 14:59:57
date last changed
2024-12-17 16:03:02
@article{3b2a20bd-bf64-48b3-b2cb-3956a6f24334,
  abstract     = {{<p>The diagnosis of lymphoma relies mainly on clinical examination and laboratory explorations. Among the latter, morphological and immunohistochemical analysis of a tissue biopsy are the cornerstones for proper identification and classification of the disease. In lymphoma with blood and/or bone marrow involvement, multiparameter flow cytometry is useful. This technique can also be applied to fresh cells released from a biopsy sample. For full comprehension of lymphomas, surgical biopsies are best and indeed recommended by the hematopathological community. Currently, however, there is a global trend towards less invasive procedures, resulting in smaller samples such as core needle biopsies or fine needle aspirations which can make the diagnosis quite challenging. In this review, the possibilities and limitations to make an accurate lymphoma diagnosis on such small volume material are presented. After recalling the major steps of lymphoma diagnosis, the respective value of histology, cytology, and flow cytometry is discussed, including handling of small specimens. The benefits of an integrated approach are then evoked, followed by discussion about which attitude to adopt in different contexts. Perhaps contrary to the prevailing view among many pathologists, a full diagnosis on small volume material, combined with relevant ancillary techniques, is often possible and indeed supported by recent literature. A glimpse at future evolutions, notably the merit of artificial intelligence tools, is finally provided. All in all, this document aims at providing pathologists with an overview of diagnostic possibilities in lymphoma patients when confronted with small volume material such as core needle biopsies or fine needle aspirations.</p>}},
  author       = {{Ehinger, Mats and Béné, Marie C.}},
  issn         = {{0945-6317}},
  keywords     = {{Biopsy; Cytology; Diagnosis; Fine needle; Flow cytometry; Lymphoma}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{591--604}},
  publisher    = {{Springer}},
  series       = {{Virchows Archiv}},
  title        = {{Morphology and multiparameter flow cytometry combined for integrated lymphoma diagnosis on small volume samples : possibilities and limitations}},
  url          = {{http://dx.doi.org/10.1007/s00428-024-03819-3}},
  doi          = {{10.1007/s00428-024-03819-3}},
  volume       = {{485}},
  year         = {{2024}},
}