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32
ICCS 2012
P3
EUROFLOW™ LST, A VERY USEFUL
8-COLOR SCREENING TUBE FOR CHRONIC
LYMPHOPROLIFERATIVE DISORDERS
Maria J. Arroz, José M. Pereira, Maria J. Acosta, Lylliane Luz,
Ana P. Costa, Sílvia Amaro, M. Esmeraldina C. Júnior
CHLO, S. Francisco Xavier Hospital, Clinical Pathology
Department
Aim:
To evaluate the efficiency of screening CLPD using an
8-color, containing 11 monoclonal antibodies, single tube, in
different types of specimens.
Material and methods:
A total
of 1000 fresh samples of peripheral blood (502), bone marrow
aspirates (342), pleural effusions (44), peritoneal effusions
(10), FNAs and lymph node biopsies (73), BAL (5), CSF (7)
and other tissues (17), were processed using the LST™ tube
without the gamma-delta reagent: CD20+CD4 Pacific Blue/
CD45 Pacific Orange/Lambda +CD8 FITC/ Kappa+CD56 PE/
CD5 PerCP CY5.5/ CD19 PC7/ CD3 APC/ CD38 APC-H7.
The majority of the requests were based on the suspicion of
CLPD (75.5%) or evidence of cytopenias (20.7%). Infinicyt™
software was used for analysis, performing a sequential
strategy based on the identification of T cells and their
subsets, B cells with their light chain expression, and NK
cells. Moreover, when applied to a bone marrow sample, it
can also identify B cell maturation and plasma cells.
Results:
Based on the analysis of this single tube, we were able to
identify 299 abnormal samples, of which 261 were B-CLPD,
17 T and NK-CLPD and 16 plasma cell disorders. 40.5% of
the abnormal samples had a final diagnosis of B-CLL, which
was strongly suspected upon the analysis of this tube and
confirmed by a second 8-color tube. Conclusion: 3 years of
routine experience using this single tube demonstrate that
it is a very powerful screening tool for all types of samples,
at a relative low cost when compared to the previous use of
multiple tubes.
P4
ABNORMAL EXPRESSION OF CD20 ON IGG4 PLASMA
CELLS
Antony C Bakke
1
, Kate Grimm
2
, Dennis P O’Malley
2 1
Clarient-
GEHC,
2
Clarient Pathology Services
Context:
IgG4-related sclerosing disease (IgG4-RD) is a
newly described entity which presents as mass forming
lesions in soft tissue, exocrine glands and in lymph nodes as
IgG4-related lymphadenopathy (IgG4-RL). The underlying
pathologic mechanism of IgG4-RD is unclear, however
rituximab (an anti-CD20 monoclonal antibody) has been
shown to have clinical efficacy.
Objective:
To look for the
presence or absence of CD20 on the IgG4 expressing
plasma cells in IgG4-RL.
Design:
Cases were identified
through a retrospective review from the files at Clarient/
GE healthcare. Patients were selected by the presence of
a lymph node biopsy with increased IgG4 plasma cells by
immunohistochemistry and a histologic diagnosis compatible
with IgG4-RL and flow cytometry performed on a concurrent
sample. Twelve cases were identified.
Results:
We report
dim CD20 expression on plasma cells in all cases where
a plasma cell population was clearly identified by flow
cytometry. These cases were from patients with lymph
node biopsies that met published criteria for IgG4-RL.
Conclusions:
This finding may be one potential explanation
for the clinical efficacy of rituximab in IgG4-RD.
POSTER ABSTRACTS