Flow cytometric detection of malignant cells in body fluids

原发性渗出性淋巴瘤是一种侵袭性淋巴瘤，发生在HIV感染的情况下， HHV8主要涉及体液。多中心Castlemans病是一种非克隆性 在相同的临床环境中出现的增殖过程。形态学诊断是 在这些罕见的疾病。我们已经开发了临床流式细胞术检测， 有助于原发性渗出性淋巴瘤和多中心Castleman病的诊断， 为NCI协议的患者提供关键的临床支持。累及脑脊液 造血系统恶性肿瘤的脑脊液（CSF）也可能难以通过形态学记录 一个人在一项比较单纯形态学与流式细胞术形态学的研究中，我们 表明流式细胞术免疫分型在建立诊断中是有用的。 一系列已知患有淋巴瘤或白血病的患者中的肿瘤形成， “非典型”或“可疑”CSF。流式细胞术单位评价 流式细胞术在高B分级患者分期和治疗中作用 细胞淋巴瘤流式细胞术鉴定了肿瘤克隆， 占总CSF淋巴细胞的0.02%。流式细胞术检测到细胞学、化学 细胞计数失败流式细胞术检测疾病是一个消极的预后因素 并且现在提示治疗干预。研究结果建议， 有侵袭性B细胞淋巴瘤累及CNS风险的患者接受CSF分期 通过流式细胞术评价。流式细胞术单位参加了一个国际会议， 确定流式细胞术分析的最佳方法的共识会议 脑脊液。

Primary effusion lymphoma is an aggressive lymphoma arising in the setting of HIV and HHV8 that primarily involves body fluids. Multicentric Castlemans disease is a non-clonal proliferative process that arises in the same clinical setting. Morphological diagnosis is difficult in these rare diseases. We have developed clinical flow cytometric assays that can aid in the diagnosis of primary effusion lymphoma and multicentric Castlemans disease, providing key clinical support to patients on NCI protocols. Involvement of the cerebrospinal fluid (CSF) by hematopoietic malignancies may also be difficult to document by morphology alone. In a study comparing morphology alone to morphology with flow cytometry, we demonstrated that flow cytometric immunophneotyping was useful in establishing a diagnosis of neoplasia in a series of patients with known lymphoma or leukemia and an initial diagnosis of "atypical" or "suspicious" CSF using morphologic criteria. The Flow Cytometry Unit evaluated the role of flow cytometric analysis in staging and management of patients with high grade B cell lymphomas. Flow cytometry identified neoplastic clones that constituted as little as 0.02% of total CSF lymphocytes. Flow cytometry detected involvement where cytology, chemistry and cell counts failed. Flow cytometric detection of disease was a negative prognostic factor and now prompts therapeutic intervention. As a result of the study it is recommended that patients at risk for CNS involvement by aggressive B cell lymphoma undergo staging CSF evaluation by flow cytometry. The Flow Cytometry Unit participated in an international consensus conference to determine optimal methodology for flow cytometric analysis of CSF.