Savanah  D. Gisriel,Kristle Haberichter,Sara Huang,James Z.  Huang,
Flow Cytometry Analysis of Recurrent or Persistent Lymphadenopathy in Patients  with Nodular Lymphocyte-Predominant Hodgkin Lymphoma
Clinical Oncology and Research
2021
2613-4942
http://dx.doi.org/10.31487/j.COR.2021.08.05
https://www.sciencerepository.org/flow-cytometry-analysis-of-recurrent-or-persistent-lymphadenopathy_COR-2021-8-105 
Abstract: Objectives: We recently examined the utility of flow cytometric analysis in the diagnosis of nodular 
lymphocyte predominant Hodgkin lymphoma (NLPHL) by examining reactive T-cell features. This study 
aims to compare these features in sequential biopsies of persistent or recurrent lymphadenopathy in patients 
with NLPHL.
Methods: We reanalysed the histopathology and flow cytometry findings of 9 patients with multiple 
biopsies for persistent or recurrent lymphadenopathy and either initial or recurrent NLPHL. A flow 
cytometry signature was considered suggestive of NLPHL if ≥12% of T-cells expressed CD57 or ≥3% of 
T-cells co-expressed CD4 and CD8.
Results: A flow cytometry signature considered suggestive of NLPHL was seen in 18 of 20 specimens. 
Based on histopathology, 11 were diagnosed as NLPHL, 3 were initially underdiagnosed as atypical 
lymphoid proliferation, and 4 were initially incorrectly diagnosed as negative or progressive transformation 
of germinal centers. Flow cytometry showed similar expression patterns of CD57 and CD4/CD8 in T-cells 
between initial and subsequent biopsies. The remaining 2 specimens lacked the flow cytometry signature 
suggestive of NLPHL and were histopathologically diagnosed as reactive hyperplasia.
Conclusion: Flow cytometry analysis based on our criteria is highly sensitive in detecting NLPHL. 
Correlation with the cytospin cytology may increase the diagnostic specificity. A negative flow essentially 
ruled out the possibility of NHLPHL.
Keywords: Hematopathology, Immunopathology, flow cytometry, nodular lymphocyte-predominant Hodgkin lymphoma, NLPHL