Flow Cytometry in the Differential Diagnosis of CD10-Positive Nodal Lymphomas

Abstract

Abstract Background Differences between follicular lymphoma (FL) and diffuse large B-cell lymphoma/high-grade B-cell lymphoma (DLBCL/HGBL) by flow cytometry are underexplored. Methods We retrospectively assessed flow cytometry results from 191 consecutive lymph node biopsies diagnosed with FL or DLBCL/HGBL. Results The only parameters that differed between the 2 groups in the derivation cohort were forward scatter and side scatter (P < 10–6; area under the curve [AUC], 0.75–0.8) and %CD23 (P = .004; area under the receiver characteristic operating curve, 0.64). However, since light scatter characteristics did not distinguish between grade 3 FL and DLBCL/HGBL, we set out to develop a model with high sensitivity for the exclusion of the latter. Several models, including FS and %CD23, were tested, and 2 models showed a sensitivity of >0.90, with negative predictive values of ≥0.95, albeit with low specificity (0.45 to 0.57). Conclusion Two simple models enable the exclusion of DLBCL/HGBL with a high degree of confidence.