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Year : 2021  |  Volume : 18  |  Issue : 4  |  Page : 364-370

Flowcytometry aiding morphological diagnosis of mature B-cell neoplasm in patients with lymphocytosis

1 Department of Pathology, Laboratories of Al-Yarmouk Teaching Hospital, Baghdad, Iraq
2 Laboratory Department, Haematology Unit, Baghdad Teaching Hospital, Baghdad, Iraq

Correspondence Address:
Husham Raad Abbas
Department of Pathology, Laboratories of Al-Yarmouk Teaching Hospital, Baghdad.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/MJBL.MJBL_51_21

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Background: Mature B-cell neoplasms (MBCNs) are a category of disorders with a broad range of clinical manifestations, pathologic features, and outcomes that share common characteristics. They originate from the B-cell lineage, are clonal, and have the immunophenotypic and genetic features of mature B-cells. Flow cytometry (FC) is a widely used method for diagnosing suspected lymphoproliferative disorders in patients with lymphocytosis, lymphadenopathy, and other lymphoproliferative disorders. Aim: To evaluate the role of FC in confirming the provisional morphologic diagnosis in patients with MBCNs. Materials and Methods: This is a retrospective; descriptive study conducted on 193 adult patients newly diagnosed with MBCNs; immunophenotypic findings of the patients were reviewed. The B lymphocytes were identified according to their Side-Scattered/CD19 distribution. Results: Chronic lymphocytic leukemia (CLL) was the most common subtype (127, 65.9%). Splenomegaly was noted more frequently in hairy cell leukemia variant cases (85.7%) and hairy cell leukemia cases (75%). The anemia at presentation was the least frequent in CLL (20%). The CD5+/CD23+ phenotype of CLL was seen in 114 cases (90%); negativity for FMC7 showed high sensitivity (93.7%) and sufficient specificity (60%) in the diagnosis of CLL. Conclusions: It is difficult to diagnose B-chronic lymphoproliferative disorders solely based on morphologic findings. Consequently, FC findings combined with clinical, hematologic, and morphologic features can confidently result in a precise diagnosis.

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