DNA-PLOIDY, PROLIFERATIVE ACTIVITIES, AND IMMUNOPHENOTYPE OF MALIGNANT-LYMPHOMA - APPLICATION OF FLOW-CYTOMETRY

Background. To explore the flow cytometric diagnosis of malignant lymp homa, we examined the deoxyribonucleic acid (DNA) ploidy, proliferativ e activities, and immunophenotype of surgical biopsy- and fine-needle aspiration (FNA)-derived materials. Our goal was to determine the poss ibility of making a diagnosis of malignant lymphoma by flow cytometric analysis of FNA-derived materials. Methods. The DNA ploidy and prolif erative indices including the percentage of S-phase fraction (SPF), G2 + M fraction (G2M), and Ki-67-positive fraction (Ki-67) were analyzed on the fresh materials from 84 consecutive patients with suspected ma lignant lymphoma. Flow cytometric analysis of surface antigens was sim ultaneously performed. Fourteen of the patients underwent FNA and subs equent surgical biopsy of the same lymph nodes for flow cytometric ana lysis. Results. The proliferative indices of intermediate-grade non-Ho dgkin's lymphomas (NHL) (n = 88) and high-grade NHL (n = 23) were sign ificantly higher than those of the reactive hyperplasia (n = 25). The total for SPF + G2M of 6% was a satisfactory threshold for differentia ting these NHL from reactive hyperplasia (sensitivity of 84%, specific ity of 88%, and accuracy of 86%). However, low-grade NHL (n=3) and Hod gkin's lymphoma (HL, n = 5) could not be discriminated by employing th is parameter. DNA aneuploidy was seen in 13 of the 28 intermediate-gra de NHL and 8 of the 23 high-grade NHL, whereas it was not seen in 25 r eactive hyperplasia, 3 low-grade NHL, and 5 HL. The percentage of CD19 -positive cells in B-cell NHL or CD3-positive cells in T-cell NHL was significantly higher compared with those for reactive hyperplasia. The percentage of CD16 + CD56-positive cells in natural killer (NK) cell NHL was extremely high, with a mean of 91.8%. Flow cytometric results for FNA-derived materials showed excellent correlation with those for surgical biopsy-derived specimens. Conclusions. Analyses of DNA ploidy , proliferative activities, and immunophenotype by flow cytometry (FCM ) are useful for diagnosing intermediate- and high-grade NHL. Fine-nee dle aspiration is a less invasive approach than surgical biopsy, and, when combined with FCM, it may have a place in the diagnosis of NHL. ( C) 1998 John Wiley & Sons, Inc.