ROLE OF FLOWCYTOMETRIC IMMUNOPHENOTYPING IN CHRONIC LYMPHOPROLIFERATIVE DISORDERS: A 6-YEAR STUDY

2021 ◽  
pp. 68-71
Author(s):  
Vijay Kumar ◽  
Manjari Kishore ◽  
Shruti Dogra ◽  
Sadhna Marwah ◽  
Devender Singh Chauhan
Keyword(s):  
B Cell ◽  
Care Center ◽  
Tertiary Care ◽  
Lymphoproliferative Disorders ◽  
Lymphocytic Leukemia ◽  
North India ◽  
Severe Neutropenia ◽  
Splenic Marginal Zone Lymphoma ◽  
Prolymphocytic Leukemia ◽  
Male Preponderance

INTRODUCTION:Chronic B-cell lymphoproliferative disorders (B-CLPD) are a biologically heterogeneous group of malignant diseases most often diagnosed by ow cytometric immunophenotyping that identies a clonal light-chain restricted population expressing B-cell markers in the blood or BM. Flowcytometric studies not only conrm a malignant diagnosis but, in most cases, allow accurate categorization into distinct pathologic entities. AIMS & OBJECTIVE:The present study is undertaken to study the spectrum and pattern of antigen expression in chronic lymphoproliferative disorders (CLPD) encountered at a tertiary care center of North India. MATERIALS & METHODS:This is a retrospective study done in the Department of Pathology over a period of 6 years. Basic clinical and hematological details were collected from the reports. The panel of monoclonal antibodies used for analysis of CLPD included: CD45, CD10, CD5, CD19, CD20, CD23, FMC, CD79b, CD3, CD22, CD25, CD103, CD38, kappa and lambda. RESULTS:A total of 52 cases of CLPD were analysed. The age of the patients ranged from 49 to 80 years with a mean age of 65.5 years and male preponderance. There was male preponderance with M:F:: 2.07:1. The common presenting features were fever and weight loss, lymphadenopathy, splenomegaly, peripheral lymphocytosis along with various other signs & symptoms like fatigue, recurrent infections, severe neutropenia, peripheral neuropathy. Among 52 cases of CLPD, on detailed owcytometric immunophenotyping, majority of cases were found to be of Chronic lymphocytic leukemia (CLL, 77%) followed by Mantle cell lymphoma (12%), Splenic marginal zone lymphoma (SMZL, 5%), Prolymphocytic leukemia (2%), Hairy cell leukemia (2%), Burkitt lymphoma (2%). The classical immunophenotype prole of each entity in our study has been summarized in a tabular form. CONCLUSION:The current study highlights the importance of a systematic approach encompassing of clinicohematological prole, bone marrow examination and FCM immunophenotyping in arriving at a diagnosis of various subtypes of CLPDs. This multipronged approach is important for an accurate diagnosis of CLPDs, thereby providing better management for patients.

CD11b Is Useful in the Diagnosis of Chronic Lymphocytic Leukemia/Prolymphocytic Leukemia, Mixed Chronic Lymphocytic Leukemia, and Prolymphocytic Leukemia.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4806-4806
Author(s):  
William Fricke
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
B Cell ◽  
Marginal Zone ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Lymphoproliferative Disorders ◽  
Marginal Zone Lymphoma ◽  
Lymphocytic Leukemia ◽  
Splenic Marginal Zone Lymphoma ◽  
Prolymphocytic Leukemia

Abstract CD11b is well known as an integrin, Mac-1, is often complexed with CD18, and is found on monocytes, granulocytes, and natural killer cells. It also serves as a receptor for iC3b. However, its occurrence in B cell chronic lymphoproliferative disorders is not generally recognized and has not been fully evaluated. To address this issue, a series of B cell leukemias and lymphomas referred for primary diagnosis was evaluated for the presence of CD11b. The purpose was to determine the frequency of its expression on these tumors and to evaluate its diagnostic value. Consecutive cases referred for flow cytometry as possible lymphoproliferative disease were analyzed. Included were bone marrow, peripheral blood, and lymph nodes. All cases were diagnosed according to the WHO classification based on immunophenotypic, morphologic, and clinical findings. The morphologic criteria of Melo (1986) and Bennett (1989) were used for classification of chronic lymphocytic leukemia (CLL), CLL/prolymphocytic leukemia (CLL/PLL), mixed CLL, and PLL. Cases identified as not related to chronic lymphocytic leukemia or prolymphocytic leukemia were recorded but not further analyzed. Similarly, lymph node and spleen-based tumors were excluded from the final analysis. CD11b was present on cells from 32 of 123 cases, including occasional follicular lymphoma, (5/35); mantle cell lymphoma, (1/8); diffuse large B cell lymphoma, (3/9); hairy cell leukemia, (3/5); multiple myeloma, (1/2); lymphoplasmacytic lymphoma, (2/2); nodal marginal zone lymphoma, 0/1); and splenic marginal zone lymphoma, (1/1). However, it was most consistently expressed on CLL that contained increased numbers of prolymphocytes or large cells and on PLL. A total of 16 such cases were found. Morphologic assessment showed them to include 8 CLL/PLL, 3 mixed CLL, 4 PLL, and 1 typical CLL. The typical CLL case included both large cells and prolymphocytes but did not have more than 10% PLs. Five of the 16 cases (31%) were negative for CD5, CD23, and CD38 but were positive for FMC-7. In contrast, the other 11 cases were all CD5(+) and CD23(+); 3/11 were positive for CD38; and 5/11 were positive for FMC-7. Forty-five CLLs also were identified during the study, of which 27 had sufficient data for comparison. Twenty-six of the 27 CLLs were morphologically typical. The remaining case was mixed CLL. All of the CLLs were CD11b(−), CD5(+) and CD23(+); 15/43 were CD38(+), and 6/43 were FMC-7(+). The findings show that CD11b is expressed on chronic B cell lymphoproliferative disorders. In particular, it is expressed on almost all CLL cases that contain large cells or prolymphocytes and on PLL. Inclusion of CD11b in routine screening panels of possible chronic B cell leukemiaa will improve diagnosis of these disorders.

Diffuse large B-cell lymphoma: experience from a tertiary care center in north India

2009 ◽  
Vol 27 (2) ◽  
pp. 310-318 ◽  
Author(s):  
Rohan Khera ◽  
Snigdha Jain ◽  
Lalit Kumar ◽  
S. Thulkar ◽  
M. Vijayraghwan ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Care Center ◽  
Tertiary Care ◽  
B Cell Lymphoma ◽  
North India ◽  
Tertiary Care Center ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals Splenic B-Cell Lymphomas with Diffuse Cyclin D1 Protein Expression and Increased Prolymphocytic Cells: A Previously Unrecognized Diagnostic Pitfall

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Khaled Algashaamy ◽  
Yaohong Tan ◽  
Nicolas Mackrides ◽  
Alvaro Alencar ◽  
Jing-Hong Peng ◽  
...  
Keyword(s):  
Protein Expression ◽  
B Cell ◽  
Cyclin D1 ◽  
D1 Protein ◽  
Diagnostic Errors ◽  
Lymphocytic Leukemia ◽  
Splenic Marginal Zone Lymphoma ◽  
B Cell Lymphomas ◽  
Prolymphocytic Leukemia ◽  
Diagnostic Pitfall

Prolymphocytic transformation is a concept usually applied in the context of chronic lymphocytic leukemia/small lymphocytic lymphoma to describe the presence of a high percentage of prolymphocytes in peripheral blood (usually more than 55%). Prolymphocytic transformation has also been reported in mantle cell lymphoma (MCL) but only rarely in splenic marginal zone lymphoma (SMZL). We present two splenic B-cell lymphomas presenting in the leukemic phase and with increased prolymphocytes, both classified as SMZL with prolymphocytic transformation. One case clinically simulated B-prolymphocytic leukemia (B-PLL). Both lymphomas were very unusual because the tumor cells diffusely and strongly expressed cyclin D1 despite lacking the t(11; 14)(q13; q32) as detected by several approaches including next-generation sequencing, fluorescence in situ hybridization using CCND1 break apart probe and fusion probes for t(11; 14)(q13; q32), and conventional karyotyping. These cases therefore simulated prolymphocytic variants of MCL. The incidence of this phenomenon is unknown, and awareness of this potential alternate protein expression pattern is important in order to avoid diagnostic errors.

scholarly journals Possible specific chromosome change in prolymphocytic leukemia

Blood ◽  
1983 ◽  
Vol 62 (4) ◽  
pp. 729-736
Author(s):  
N Sadamori ◽  
T Han ◽  
J Minowada ◽  
ML Bloom ◽  
ES Henderson ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
B Cell ◽  
De Novo ◽  
Chromosome Abnormality ◽  
Lymphoproliferative Disorders ◽  
Lymphocytic Leukemia ◽  
Specific Chromosome ◽  
Prolymphocytic Leukemia ◽  
Chromosome Change ◽  
Blood Lymphocytes

The chromosomes of unstimulated and stimulated blood lymphocytes from 5 cases with B-cell prolymphocytic leukemia (PLL) were examined following the use of polyclonal B-cell activators (PBA). Banding techniques revealed a common and specific chromosome abnormality to be present in each of the cases, which was due to a translocation between chromosomes 6 and 12 (t(6;12)(q15;p13]. The fact that this specific chromosome change has not been reported in other lymphoproliferative disorders may indicate that PLL is a distinct clinical entity and different from other lymphoproliferative disorders, whether it occurs de novo or complicates chronic lymphocytic leukemia (CLL).

scholarly journals Possible specific chromosome change in prolymphocytic leukemia

Blood ◽  
1983 ◽  
Vol 62 (4) ◽  
pp. 729-736 ◽  
Author(s):  
N Sadamori ◽  
T Han ◽  
J Minowada ◽  
ML Bloom ◽  
ES Henderson ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
B Cell ◽  
De Novo ◽  
Chromosome Abnormality ◽  
Lymphoproliferative Disorders ◽  
Lymphocytic Leukemia ◽  
Specific Chromosome ◽  
Prolymphocytic Leukemia ◽  
Chromosome Change ◽  
Blood Lymphocytes

Abstract The chromosomes of unstimulated and stimulated blood lymphocytes from 5 cases with B-cell prolymphocytic leukemia (PLL) were examined following the use of polyclonal B-cell activators (PBA). Banding techniques revealed a common and specific chromosome abnormality to be present in each of the cases, which was due to a translocation between chromosomes 6 and 12 (t(6;12)(q15;p13]. The fact that this specific chromosome change has not been reported in other lymphoproliferative disorders may indicate that PLL is a distinct clinical entity and different from other lymphoproliferative disorders, whether it occurs de novo or complicates chronic lymphocytic leukemia (CLL).

Evaluation of Various Diagnostic Techniques for the Diagnosis of Pulmonary and Extra Pulmonary Tuberculosis at a Tertiary Care Center in North India

2020 ◽  
Vol 20 (4) ◽  
pp. 433-439
Author(s):  
Monika Rajani ◽  
Molay Banerjee
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Diagnostic System ◽  
Diagnostic Techniques ◽  
Automated System ◽  
North India ◽  
Mortality And Morbidity ◽  
Indicator Tube ◽  
Extra Pulmonary ◽  
Uv Lamp

Introduction: Tuberculosis (TB) is a one of the main causes of mortality and morbidity worldwide. Bactec MGIT (Mycobacteria Growth Indicator Tube) system is a rapid, reliable automated system for early diagnosis of pulmonary and extra pulmonary TB in setups where purchase of expensive instruments is not possible. The present study was thus carried out to evaluate AFB microscopy, culture on Lowenstein Jensen media and micro MGIT system for early and accurate diagnosis of Tuberculosis. Methods: A total of 280 samples were processed for direct AFB smear examination, and culture on micro MGIT and LJ media. The identification of Mycobacterium tuberculosis complex in positive cultures was done by MPT64 Ag card test (BD MGIT TBC Identification Test). Results: Out of the processed samples, (47.1%) 132/280 were positive for Mycobacterium spp by Micro MGIT, (35%) 98/280 on LJ medium and (25.7%) 72/280 by AFB smear. A total of (48.5%) 136 samples were positive by a combination of Micro MGIT and LJ medium. Among the total positive samples (136/280), Micro MGIT was found to be positive in 97% (132/136) of samples, LJ was positive in 72% (98/136), while 52.9% (72/136) were positive by AFB smear. Conclusion: Manual MGIT System is a simple and efficient, safe to use the diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for the detection of fluorescence. In areas with limited resources where the purchase of expensive instruments such as the MGIT 960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be an option. We would recommend testing MGIT 960 using first and secondline drugs to determine DST.

Outcomes of radiocephalic fistula created by nephrologists

2019 ◽  
Vol 20 (6) ◽  
pp. 615-620
Author(s):  
Narayan Prasad ◽  
Venkatesh Thammishetti ◽  
DS Bhadauria ◽  
Anupama Kaul ◽  
RK Sharma ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Care Center ◽  
Tertiary Care ◽  
Primary Patency ◽  
North India ◽  
Maintenance Hemodialysis ◽  
Secondary Patency ◽  
Arteriovenous Fistulas ◽  
Secondary Failure ◽  
Stage Renal Disease

Introduction: Arteriovenous fistula is considered as gold standard access for maintenance hemodialysis. Due to increasing burden of end-stage renal disease requiring dialysis, it is important for nephrologists to complement creation of arteriovenous fistula to meet the demand. Methods: This retrospective study was designed to assess the outcomes of arteriovenous fistula made by nephrologists at a tertiary care center from North India. The study included all radiocephalic arteriovenous fistula performed by nephrologists between November 2015 and January 2017. All arteriovenous fistulas were performed in patients whose duplex ultrasonography revealed both arterial and venous diameter of at least 2 mm. Data were collected with regard to age, gender, dialysis status, basic diseases, co-morbidities, and mineral bone disease parameters. The predictors of the primary and secondary patency rates were analyzed. Results: Five hundred patients (age 39.3 ± 14.4 years; 82.4% males; 21.6% diabetics) were included. In total, 83 (16.6%) patients had primary failure and 31 (7%) patients had secondary failure. Diabetes was associated with poor primary and secondary patency rates. Mean survival among the patients without primary failure was 11 months. The primary patency rates at 3, 6, 12, 18, and 21 months were 82%, 78%, 73%, 70%, and 70%, respectively. Conclusion: To conclude, the outcomes of radiocephalic arteriovenous fistulas created by nephrologists are at par with historic outcomes.

scholarly journals Effectiveness of Transjugular Intrahepatic Portosystemic Shunt in Variceal Bleeding: An Audit from a Tertiary Care Center in North India

2017 ◽  
Vol 01 (03) ◽  
pp. 150-155
Author(s):  
Arun Gupta ◽  
Ajay Mehta ◽  
Nitin Mishra ◽  
Rajendra Bansal ◽  
Ajit Yadav
Keyword(s):  
Variceal Bleeding ◽  
Patency Rate ◽  
Care Center ◽  
Tertiary Care ◽  
Portosystemic Shunt ◽  
North India ◽  
Related Complication ◽  
Variceal Bleed ◽  
Intrahepatic Portosystemic Shunt

AbstractVariceal bleeding is one of the most feared complications of cirrhosis and portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) is an effective minimally invasive option to achieve adequate decompression of the portal system. The aim of the study was to assess the efficacy and complications of TIPS in patients presenting with variceal bleed. It was a retrospective study done in a tertiary care center in North India in cirrhotic patients with acute or recurrent variceal bleed who underwent TIPS from April 2010 to October 2013. All the patients were followed up till April 2014. We could successfully implant TIPS in 100% of our patients with 100% success rate in controlling variceal bleeding immediately and during the follow-up period. Our primary patency rate was 94.5% and overall patency rate was 100%. Major TIPS-related complication was hepatic encephalopathy in 20% of patients; 7 of 22 patients died during the follow-up period. TIPS is a safe and effective procedure for control of acute or recurrent variceal bleed. Emerging evidence in favor of early TIPS is further going to expand its indication in variceal bleed. Hepatic encephalopathy was the major procedure-related complication in our study consistent with previous literature reports.

A Study on Prevalence and Seasonal Distribution of Dengue at a Tertiary Care Centre of North India

Healthline ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 100-107
Author(s):  
Arti Agrawal ◽  
Vikas Kumar ◽  
Sanjeev Kumar ◽  
Neha K Mani
Keyword(s):  
Monsoon Season ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Seasonal Distribution ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Post Monsoon ◽  
Post Monsoon Season ◽  
Male Preponderance

Introduction: Dengue virus infection is a major public health issue prevalent in tropical and sub-tropical countries all over the world mostly in urban and semi-urban areas. WHO estimates about 50-100 million dengue infections worldwide every year. The present study is aimed to assess the prevalence and seasonal distribution of dengue disease during three consecutive years from 2016-2018 at a tertiary care centre of North India. Method: This is an observational retrospective study conducted on total 6,481 clinical suspected cases referred from indoor and outdoor departments of Medicine and Pediatrics of one of the medical colleges of Agra during the period from 1st January 2016 to 31st December 2018. Results: The maximum positivity was recorded in the year 2016 (16.66%), followed by 2017 (14.07%) and 2018(13.56%).Our study shows male preponderance with maximum cases in the year 2018 was recorded in the month of October (22.75%) whereas the lowest in the month of May (1.96%). Most of the cases were in the age group 0-30 years with a male preponderance. The outbreak occurred during the months of August to November indicating vector transmission in the monsoon and post-monsoon season. Conclusion: From the analysis, this study reflects that the numbers of dengue cases in 2016 were maximum and outnumbered the dengue cases among three consecutive years from 2016 to 2018. The peak in dengue positivity was observed during September to October. As this disease affects the population in the monsoon and post monsoon months therefore continuous monitoring of dengue infection is important during the post-monsoon season.

Sign in / Sign up

Export Citation Format

Share Document