Scott Gregory David, Atwater Susan K, Gratzinger Dita A
Department of Pathology, Stanford Hospital and Clinics, Stanford, California, USA.
J Clin Pathol. 2018 Feb;71(2):174-179. doi: 10.1136/jclinpath-2017-204687. Epub 2017 Sep 15.
To create clinically relevant normative flow cytometry data for understudied benign lymph nodes and characterise outliers.
Clinical, histological and flow cytometry data were collected and distributions summarised for 380 benign lymph node excisional biopsies. Outliers for kappa:lambda light chain ratio, CD10:CD19 coexpression, CD5:CD19 coexpression, CD4:CD8 ratios and CD7 loss were summarised for histological pattern, concomitant diseases and follow-up course.
We generated the largest data set of benign lymph node immunophenotypes by an order of magnitude. B and T cell antigen outliers often had background immunosuppression or inflammatory disease but did not subsequently develop lymphoma.
Diagnostic immunophenotyping data from benign lymph nodes provide normative ranges for clinical use. Outliers raising suspicion for B or T cell lymphoma are not infrequent (26% of benign lymph nodes). Caution is indicated when interpreting outliers in the absence of excisional biopsy or clinical history, particularly in patients with concomitant immunosuppression or inflammatory disease.
为研究较少的良性淋巴结创建临床相关的标准化流式细胞术数据，并对异常值进行特征描述。
收集了380例良性淋巴结切除活检的临床、组织学和流式细胞术数据，并对分布情况进行了总结。总结了κ:λ轻链比值、CD10:CD19共表达、CD5:CD19共表达、CD4:CD8比值和CD7缺失的异常值的组织学模式、伴随疾病和随访过程。
我们生成了数量级上最大的良性淋巴结免疫表型数据集。B和T细胞抗原异常值通常伴有背景免疫抑制或炎症性疾病，但随后并未发展为淋巴瘤。
良性淋巴结的诊断性免疫表型数据提供了临床使用的标准化范围。引起对B或T细胞淋巴瘤怀疑的异常值并不少见（占良性淋巴结的26%）。在没有切除活检或临床病史的情况下解释异常值时应谨慎，尤其是在伴有免疫抑制或炎症性疾病的患者中。
