Normative data for flow cytometry immunophenotyping of benign lymph nodes sampled by surgical biopsy

J Clin Pathol. 2018 Feb;71(2):174-179. doi: 10.1136/jclinpath-2017-204687. Epub 2017 Sep 15.

Abstract

Aims: To create clinically relevant normative flow cytometry data for understudied benign lymph nodes and characterise outliers.

Methods: Clinical, histological and flow cytometry data were collected and distributions summarised for 380 benign lymph node excisional biopsies. Outliers for kappa:lambda light chain ratio, CD10:CD19 coexpression, CD5:CD19 coexpression, CD4:CD8 ratios and CD7 loss were summarised for histological pattern, concomitant diseases and follow-up course.

Results: We generated the largest data set of benign lymph node immunophenotypes by an order of magnitude. B and T cell antigen outliers often had background immunosuppression or inflammatory disease but did not subsequently develop lymphoma.

Conclusions: Diagnostic immunophenotyping data from benign lymph nodes provide normative ranges for clinical use. Outliers raising suspicion for B or T cell lymphoma are not infrequent (26% of benign lymph nodes). Caution is indicated when interpreting outliers in the absence of excisional biopsy or clinical history, particularly in patients with concomitant immunosuppression or inflammatory disease.

Keywords: benign; flow cytometry; immunophenotype; informatics; lymph node.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, CD19 / metabolism
  • Antigens, CD7 / metabolism
  • B-Lymphocytes / metabolism*
  • Biomarkers / metabolism
  • Biopsy
  • CD4-Positive T-Lymphocytes / metabolism
  • CD5 Antigens / metabolism
  • CD8-Positive T-Lymphocytes / metabolism
  • Child
  • Child, Preschool
  • Female
  • Flow Cytometry*
  • Follow-Up Studies
  • Humans
  • Immunophenotyping*
  • Infant
  • Lymph Nodes / immunology
  • Lymph Nodes / pathology*
  • Male
  • Middle Aged
  • Neprilysin / metabolism
  • Reference Values
  • T-Lymphocytes / metabolism*
  • Young Adult

Substances

  • Antigens, CD19
  • Antigens, CD7
  • Biomarkers
  • CD19 molecule, human
  • CD5 Antigens
  • Neprilysin