Flow Cytometry in the Differential Diagnosis of CD10-Positive Nodal Lymphomas

Lab Med. 2020 Jul 8;51(4):385-393. doi: 10.1093/labmed/lmz085.

Abstract

Background: Differences between follicular lymphoma (FL) and diffuse large B-cell lymphoma/high-grade B-cell lymphoma (DLBCL/HGBL) by flow cytometry are underexplored.

Methods: We retrospectively assessed flow cytometry results from 191 consecutive lymph node biopsies diagnosed with FL or DLBCL/HGBL.

Results: The only parameters that differed between the 2 groups in the derivation cohort were forward scatter and side scatter (P < 10-6; area under the curve [AUC], 0.75-0.8) and %CD23 (P = .004; area under the receiver characteristic operating curve, 0.64). However, since light scatter characteristics did not distinguish between grade 3 FL and DLBCL/HGBL, we set out to develop a model with high sensitivity for the exclusion of the latter. Several models, including FS and %CD23, were tested, and 2 models showed a sensitivity of >0.90, with negative predictive values of ≥0.95, albeit with low specificity (0.45 to 0.57).

Conclusion: Two simple models enable the exclusion of DLBCL/HGBL with a high degree of confidence.

Keywords: CD10; diffuse large B-cell lymphoma; flow cytometry; follicular lymphoma; high-grade B-cell lymphoma; light scatter.

MeSH terms

  • B-Lymphocytes / metabolism
  • B-Lymphocytes / pathology
  • Data Interpretation, Statistical
  • Diagnosis, Differential
  • Flow Cytometry / methods*
  • Flow Cytometry / standards
  • Humans
  • Liquid Biopsy / methods
  • Liquid Biopsy / standards
  • Lymph Nodes / pathology*
  • Lymphoma, Follicular / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / diagnosis*
  • Neprilysin / metabolism
  • Sensitivity and Specificity

Substances

  • Neprilysin