Comprehensive Flow‐Cytometry‐Based Immunophenotyping Analysis for Accurate Diagnosis and Management of Extranodal NK/T Cell Lymphoma, Nasal Type

• Published in: Cytometry. Part B, Clinical cytometry Vol. 98; no. 1; pp. 28 - 35
• Main Authors: Wang, Jian‐Chao, Deng, Xue‐Qin, Liu, Wei‐Ping, Gao, Li‐Min, Zhang, Wen‐Yan, Yan, Jia‐Qi, Ye, Yun‐Xia, Liu, Feng, Zhao, Sha
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.01.2020; Wiley Subscription Services, Inc
• Subjects: accurate diagnosis; Antigens; Biopsy; CD30 antigen; CD38 antigen; CD56 antigen; Cell activation; Diagnosis; FCM immunophenotypic characteristics; Flow cytometry; Fluorescence; Lymphocytes; Lymphocytes T; Lymphoma; Natural killer cells; Neoplasia; Neoplasms; NK/T cell lymphoma; Peripheral blood; T-cell lymphoma; therapy target selection; therapy target selection; NK/T cell lymphoma; accurate diagnosis; FCM immunophenotypic characteristics
• ISSN: 1552-4949; 1552-4957
• DOI: 10.1002/cyto.b.21838

Background Extranodal natural killer (NK)/T‐cell lymphoma, nasal type (ENKTL‐N) is an aggressive lymphoma typically diagnosed by examining small biopsy specimens. Flow cytometry is very valuable for the diagnosis and classification of several kinds of hematolymphoid neoplasms but has not been widely used for diagnosing ENKTL‐N. Methods We systematically investigated the flow cytometry characteristics of 26 solid tissue biopsy specimens of ENKTL‐N at initial diagnosis and compared the results with those from reactive NK‐cells in the nasal/nasopharyngeal region and peripheral blood. Results Our study revealed seven flow cytometry (FCM)‐based characteristics for distinguishing between the neoplastic cells and reactive NK‐cells, including (1) the proportion of NK‐cells among total lymphocytes >10%; (2) forward scatter >105; (3) mean fluorescence intensity of CD56 > 5,000; (4) aberrant antigen expression or loss; (5) skewed killer cell immunoglobulin‐like receptor repertoire; (6) homogenously positive for CD38; and (7) positive for CD30 or CD336. FCM‐based immunophenotyping is a potentially feasible and convenient approach for discriminating cellular lineages, evaluating the activation status of NK‐cells, and selecting potential therapy targets of ENKTL‐N. Conclusions Flow cytometry is very valuable for facilitating routine diagnosis, confirming clonality, predicting the cellular lineage, and guiding individual treatment for ENKTL‐N. © 2019 International Clinical Cytometry Society