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Brain stereotactic biopsy flow cytometry for central nervous system lymphoma characterization: advantages and pitfalls
BACKGROUND: Brain stereotactic biopsy (SB) followed by conventional histopathology and immunohistochemistry (IHC) is the gold standard approach for primary central nervous system lymphoma (PCNSL) diagnosis. Flow cytometry (FCM) characterization of fine-needle aspiration cytology and core needle biop...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5002320/ https://www.ncbi.nlm.nih.gov/pubmed/27567676 http://dx.doi.org/10.1186/s13046-016-0404-1 |
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author | Cordone, Iole Masi, Serena Carosi, Mariantonia Vidiri, Antonello Marchesi, Francesco Marino, Mirella Telera, Stefano Pasquale, Alessia Mengarelli, Andrea Conti, Laura Pescarmona, Edoardo Pace, Andrea Carapella, Carmine M. |
author_facet | Cordone, Iole Masi, Serena Carosi, Mariantonia Vidiri, Antonello Marchesi, Francesco Marino, Mirella Telera, Stefano Pasquale, Alessia Mengarelli, Andrea Conti, Laura Pescarmona, Edoardo Pace, Andrea Carapella, Carmine M. |
author_sort | Cordone, Iole |
collection | PubMed |
description | BACKGROUND: Brain stereotactic biopsy (SB) followed by conventional histopathology and immunohistochemistry (IHC) is the gold standard approach for primary central nervous system lymphoma (PCNSL) diagnosis. Flow cytometry (FCM) characterization of fine-needle aspiration cytology and core needle biopsies are increasingly utilized to diagnose lymphomas however, no biological data have been published on FCM characterization of fresh single cell suspension from PCNSL SB. The aim of this study was to establish the feasibility and utility of FCM for the diagnosis and characterization of brain lymphomas from a tissue samples obtained by a single SB disaggregation. METHODS: Twenty-nine patients with a magnetic resonance suggestive for PCNSL entered the study. A median of 6 SB were performed for each patient. A cell suspension generated from manual tissue disaggregation of a single, unfixed, brain SB, was characterized by FCM. The FCM versus standard approach was prospectively compared. RESULTS: FCM and IHC showed an high degree of agreement (89 %) in brain lymphoma identification. By FCM, 16 out of 18 PCNSL were identified within 2 h from biopsy. All were of B cell type, with a heterogeneous CD20 mean fluorescence intensity (MFI), CD10 positive in 3 cases (19 %) with surface Ig light chain restriction documented in 11 cases (69 %). No false positive lymphomas cases were observed. Up to 38 % of the brain leukocyte population consisted of CD8 reactive T cells, in contrast with the CD4 positive lymphocytes of the peripheral blood samples (P < 0.001). By histopathology, 18 B-PCNSL, only one CD10 positive (5 %), 1 primitive neuroectodermal tumor (PNET) and 10 gliomas were diagnosed. A median of 6 days was required for IHC diagnosis. CONCLUSION: Complementary to histopathology FCM can contribute to a better characterization of PCNSL, although necrosis and previous steroid treatment can represent a pitfall of this approach. A single brain SB is a valid source for accurate FCM characterization of both lymphoma and reactive lymphocyte population, routinely applicable for antigen intensity quantification and consistently documenting an active mechanism of reactive CD8 T-lymphocytes migration in brain lymphomas. Moreover, FCM confirmed to be more sensitive than IHC for the identification of selected markers. |
format | Online Article Text |
id | pubmed-5002320 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-50023202016-08-29 Brain stereotactic biopsy flow cytometry for central nervous system lymphoma characterization: advantages and pitfalls Cordone, Iole Masi, Serena Carosi, Mariantonia Vidiri, Antonello Marchesi, Francesco Marino, Mirella Telera, Stefano Pasquale, Alessia Mengarelli, Andrea Conti, Laura Pescarmona, Edoardo Pace, Andrea Carapella, Carmine M. J Exp Clin Cancer Res Research BACKGROUND: Brain stereotactic biopsy (SB) followed by conventional histopathology and immunohistochemistry (IHC) is the gold standard approach for primary central nervous system lymphoma (PCNSL) diagnosis. Flow cytometry (FCM) characterization of fine-needle aspiration cytology and core needle biopsies are increasingly utilized to diagnose lymphomas however, no biological data have been published on FCM characterization of fresh single cell suspension from PCNSL SB. The aim of this study was to establish the feasibility and utility of FCM for the diagnosis and characterization of brain lymphomas from a tissue samples obtained by a single SB disaggregation. METHODS: Twenty-nine patients with a magnetic resonance suggestive for PCNSL entered the study. A median of 6 SB were performed for each patient. A cell suspension generated from manual tissue disaggregation of a single, unfixed, brain SB, was characterized by FCM. The FCM versus standard approach was prospectively compared. RESULTS: FCM and IHC showed an high degree of agreement (89 %) in brain lymphoma identification. By FCM, 16 out of 18 PCNSL were identified within 2 h from biopsy. All were of B cell type, with a heterogeneous CD20 mean fluorescence intensity (MFI), CD10 positive in 3 cases (19 %) with surface Ig light chain restriction documented in 11 cases (69 %). No false positive lymphomas cases were observed. Up to 38 % of the brain leukocyte population consisted of CD8 reactive T cells, in contrast with the CD4 positive lymphocytes of the peripheral blood samples (P < 0.001). By histopathology, 18 B-PCNSL, only one CD10 positive (5 %), 1 primitive neuroectodermal tumor (PNET) and 10 gliomas were diagnosed. A median of 6 days was required for IHC diagnosis. CONCLUSION: Complementary to histopathology FCM can contribute to a better characterization of PCNSL, although necrosis and previous steroid treatment can represent a pitfall of this approach. A single brain SB is a valid source for accurate FCM characterization of both lymphoma and reactive lymphocyte population, routinely applicable for antigen intensity quantification and consistently documenting an active mechanism of reactive CD8 T-lymphocytes migration in brain lymphomas. Moreover, FCM confirmed to be more sensitive than IHC for the identification of selected markers. BioMed Central 2016-08-27 /pmc/articles/PMC5002320/ /pubmed/27567676 http://dx.doi.org/10.1186/s13046-016-0404-1 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Cordone, Iole Masi, Serena Carosi, Mariantonia Vidiri, Antonello Marchesi, Francesco Marino, Mirella Telera, Stefano Pasquale, Alessia Mengarelli, Andrea Conti, Laura Pescarmona, Edoardo Pace, Andrea Carapella, Carmine M. Brain stereotactic biopsy flow cytometry for central nervous system lymphoma characterization: advantages and pitfalls |
title | Brain stereotactic biopsy flow cytometry for central nervous system lymphoma characterization: advantages and pitfalls |
title_full | Brain stereotactic biopsy flow cytometry for central nervous system lymphoma characterization: advantages and pitfalls |
title_fullStr | Brain stereotactic biopsy flow cytometry for central nervous system lymphoma characterization: advantages and pitfalls |
title_full_unstemmed | Brain stereotactic biopsy flow cytometry for central nervous system lymphoma characterization: advantages and pitfalls |
title_short | Brain stereotactic biopsy flow cytometry for central nervous system lymphoma characterization: advantages and pitfalls |
title_sort | brain stereotactic biopsy flow cytometry for central nervous system lymphoma characterization: advantages and pitfalls |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5002320/ https://www.ncbi.nlm.nih.gov/pubmed/27567676 http://dx.doi.org/10.1186/s13046-016-0404-1 |
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