Abstract
Background
Primary central nervous system lymphoma (PCNSL), a relatively rare brain tumor, bears a dire prognosis. On occasion, rapid progression of the tumor makes immediate diagnosis and initiation of therapy imperative. To achieve swift diagnosis, we adopt flow cytometry (FCM) in addition to conventional histopathology. The aim of this study is to reveal utility and drawbacks of FCM diagnosis for PCNSL.
Methods
Patients with suspected PCNSL on neuroradiological findings and received both FCM and histological diagnosis between August 2015 and April 2020 were retrospectively enrolled into the study. Tumor samples were collected by craniotomy with either of endoscope or microscope. The patients’ electronic medical records were investigated, and histological findings, results of FCM, and other clinical data were evaluated.
Results
Twenty seven patients met the eligibility criteria. Twenty three patients (11 males and 12 females) were diagnosed with PCNSL by histological confirmation, and 22 cases were B-cell type lymphoma and 1 was T-cell type. Median age at diagnosis was 65. FCM analysis showed lymphoma pattern in 20 cases, but in the other 3 lymphoma cases (FCM discordant: FCM-D) and 4 non-lymphomatous tumor cases, FCM results did not show lymphoma pattern (sensitivity: 86.4%, specificity: 100%). Analysis of FCM-D cases showed infiltration of T lymphocytes or astrocytes into the tumor tissue, indicating tumor microenvironmental reaction, were observed, and it is assumed that those reactions deceived FCM diagnosis.
Conclusions
Despite some disadvantages, diagnosis of PCNSL by FCM is rapid and reliable.
Antemortem Diagnosis of Localized Central Nervous System Histiocytic Sarcoma in 2 Dogs
