Enhancing lymphoma diagnosis on core needle biopsies: Integrating immunohistochemistry with flow cytometry

Silvia Bellesi, Gabriele Schiaffini, Andrea Contegiacomo, Elena Maiolo, Camilla Iacovelli, Rosalia Malafronte, Simone D'Innocenzo, Eleonora Alma, Flaminia Bellisario, Marcello Viscovo, Fabrizia Campana, Alessandra De Filippis, Francesco D'Alo', Luigi Maria Larocca, Valerio De Stefano, Roberto Iezzi, Stefan Hohaus

Research output: Contribution to journalArticle

Abstract

Image-guided core needle biopsies (IG-CNB) represent a minimally invasive approach for obtaining tissue in patients with lymphadenopathy and suspected lymphoma. Despite their utility, diagnostic challenges persist, with lower efficacy compared with excisional biopsies. Our study aimed to evaluate the potential utility of incorporation of flow cytometry (FC) alongside immunohistochemistry (IHC) when performing IG-CNB for suspected lymphoproliferative diseases. Analyzing 170 consecutive cases, guided by ultrasound (n = 94) or computer tomography (n = 76), we employed a diagnostic algorithm, already established in our laboratory practice, utilizing three antibody cocktail-equipped tubes tailored for defining lymphomas, particularly those of B-cell origin. FC expedited the diagnostic process, yielding presumptive results in 87.6% of cases within 48 h, with a positive predictive value of 98%. Addition of FC to routine IHC enhanced the diagnostic rate from 91.2% to 95.3%, reducing IG-CNB failure rate by 45%, from 8.8% to 4.7%. This enhancement was particularly notable for deep-seated sites and in the setting of suspected disease recurrences. Consequently, FC emerges as a valuable adjunctive tool, allowing for the improvement of diagnostic performance, with a particular focus on the ability to quantify the expression of surface markers for targeted therapies, and holding the potential to diminish the necessity for repeat excisional biopsies subsequent to IG-CNB procedures.
Original languageEnglish
Pages (from-to)N/A-N/A
JournalCYTOMETRY. PART B, CLINICAL CYTOMETRY
DOIs
Publication statusPublished - 2024

Keywords

  • core needle biopsy
  • non-Hodgkin lymphoma
  • flow cytometry
  • diagnosis

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