Muzzafar Tariq, Wei Eric X, Lin Pei, Medeiros L Jeffrey, Jorgensen Jeffrey L
Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Arch Pathol Lab Med. 2009 Jan;133(1):49-56. doi: 10.5858/133.1.49.
Anaplastic large cell lymphoma (ALCL) is usually diagnosed by histologic and immunohistochemical analysis. However, fine-needle aspiration is becoming a popular alternative to lymph node biopsy, and flow-cytometric immunophenotyping is often used to analyze fine-needle aspiration specimens.
To review our experience using flow-cytometric immunophenotyping to assess cases of ALCL and to evaluate the diagnostic utility of this technique.
Each case of ALCL was assessed by flow cytometry with 3-color or 4-color antibody panels, and data were reanalyzed by cluster analysis using Paint-a-Gate for cases with retrievable flow cytometry data files. Anaplastic lymphoma kinase (ALK) was assessed by using immunohistochemistry.
Twenty-three ALCL cases were analyzed by flow cytometry. In 4 cases, neoplastic cells could not be identified. In the remaining 19 cases (11 ALK(+), 8 ALK(-)), all were positive for CD30 and CD45. Anaplastic large cell lymphoma cells were large and usually CD45 bright, with many or most cells falling in the region of monocytes on the CD45/side scatter plot. The frequencies of T-cell antigen expression in ALK(+) cases were CD2, 67%; CD7, 60%; CD3, 45%; CD4, 33%; CD5, 14%; and CD8, 14%. In ALK(-) cases, the frequencies of the T-cell antigen expression were CD2, 100%; CD3, 50%; CD4, 40%; CD7, 40%; CD5, 25%; and CD8, 20%.
Flow cytometry can be used to immunophenotype ALCL cases. Neoplastic cells may be few, and they may fall outside of the lymphocyte gate. Cluster analysis using software like Paint-A-Gate is often helpful because it allows for flexible, sequential gating strategies to identify and characterize the neoplastic cells.
间变性大细胞淋巴瘤（ALCL）通常通过组织学和免疫组织化学分析进行诊断。然而，细针穿刺正成为淋巴结活检的一种流行替代方法，流式细胞免疫表型分析常被用于分析细针穿刺标本。
回顾我们使用流式细胞免疫表型分析评估ALCL病例的经验，并评估该技术的诊断效用。
每例ALCL病例均通过三色或四色抗体组合进行流式细胞术评估，对于具有可检索流式细胞术数据文件的病例，使用Paint-a-Gate通过聚类分析重新分析数据。使用免疫组织化学评估间变性淋巴瘤激酶（ALK）。
通过流式细胞术分析了23例ALCL病例。4例中未识别出肿瘤细胞。在其余19例（11例ALK(+)，8例ALK(-)）中，所有病例CD30和CD45均呈阳性。间变性大细胞淋巴瘤细胞较大，通常CD45明亮，许多或大多数细胞落在CD45/侧向散射图上单核细胞区域。ALK(+)病例中T细胞抗原表达频率分别为：CD2，67%；CD7，60%；CD3，45%；CD4，33%；CD5，14%；CD8，14%。ALK(-)病例中T细胞抗原表达频率分别为：CD2，100%；CD3，50%；CD4，40%；CD7，40%；CD5，25%；CD8，20%。
流式细胞术可用于ALCL病例的免疫表型分析。肿瘤细胞可能很少，且可能落在淋巴细胞门之外。使用Paint-A-Gate等软件进行聚类分析通常很有帮助，因为它允许采用灵活的顺序门控策略来识别和表征肿瘤细胞。
