Image analytic study of nuclear area in mantle cell lymphoma

BACKGROUND: Malignant lymphomas are classified on the basis of morphology, immunohistochemistry, and genetic and molecular biological features. Morphology is considered the most important and basic feature. Lymphomas can be classified as small, medium, or large depending on the cell size, but this criterion tends to be rather subjective. The aim of this study was to investigate the usefulness of an objective approach based on quantitative measurements. METHODS: Twenty specimens of mantle cell lymphoma and 2 specimens of the tonsil were examined. The nuclear area of 6,401 tumor cells of mantle cell lymphoma and 743 normal mantle cells of reactive tonsils were measured by 3 authors by using a user-controlled image-analyzer. The images of the nuclei were outlined using the spline method and the i-solution software, and the data were assessed using ANOVA and Student's t-test. RESULTS: The mean nuclear areas of mantle cell lymphoma cells measured by the 3 authors were 37.9 [7.9] µm(2), 37.9 [7.2] µm(2), and 38.2 [7.7] µm(2) and those of normal mantle cells in reactive tonsil were 28.6 [2.3] µm(2), 28.8 [2.0] µm(2), and 27.0 [3.0] µm(2). There was no statistical difference between the 3 observations of mantle cell lymphoma (P=0.580) and normal tonsils. CONCLUSION: For morphology, nuclear area is considered an important feature in the classification schemes of lymphoma. We showed that nuclear area measurement by using image analyzer can be used as an objective quantitative method. We think that nuclear morphometry may play a significant role in the diagnosis of lymphoma.