Analysis of False-negative Findings of the Incomparable Accuracy and Swiftness of Flow Cytometric Diagnosis of Primary Central Nervous System Lymphoma
Primary central nervous system lymphoma (PCNSL), a relatively rare brain tumor, bears a dire prognosis. On occasion, the 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 conventiona...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Japan Neurosurgical Society
2023-11-01
|
| Series: | Neurologia Medico-Chirurgica |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/nmc/63/11/63_2023-0029/_pdf/-char/en |
| _version_ | 1797387874705866752 |
|---|---|
| author | Hayato TAKEUCHI Tohru INABA Yukiko SHISHIDO-HARA Taku TSUKAMOTO Shinsuke MIZUTANI Takanari OKAMOTO Seisuke TANIGAWA Takumi YAMANAKA Yoshinobu TAKAHASHI Eiichi KONISHI Junya KURODA Naoya HASHIMOTO |
| author_facet | Hayato TAKEUCHI Tohru INABA Yukiko SHISHIDO-HARA Taku TSUKAMOTO Shinsuke MIZUTANI Takanari OKAMOTO Seisuke TANIGAWA Takumi YAMANAKA Yoshinobu TAKAHASHI Eiichi KONISHI Junya KURODA Naoya HASHIMOTO |
| author_sort | Hayato TAKEUCHI |
| collection | DOAJ |
| description | Primary central nervous system lymphoma (PCNSL), a relatively rare brain tumor, bears a dire prognosis. On occasion, the 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. This study aimed to reveal the utility of FCM diagnosis for PCNSL and the cause of false-negative results of FCM diagnosis. We investigated 33 patients with suspected PCNSL on neuroradiological findings and received both FCM and histological diagnosis. The patients' electronic medical records were investigated, and histological findings, results of FCM, and other clinical data were evaluated. Overall, 27 patients (14 males and 13 females) were diagnosed with PCNSL by histological confirmation. The median age at diagnosis was 68 years. FCM analysis showed lymphoma pattern in 24 cases; however, FCM results did not show lymphoma pattern (sensitivity: 88.9%, specificity: 100%) in the other three lymphoma cases (FCM discordant: FCM-D) and six nonlymphomatous tumor cases. Analysis of FCM-D cases showed the infiltration of T lymphocytes or astrocytes into the tumor tissue, indicating tumor microenvironmental reaction; it is assumed that these reactions deceived FCM diagnosis. The survival of FCM-D patients was superior to FCM concordant counterpart, although the difference was not significant (p = 0.459). The diagnosis of PCNSL by FCM is rapid and highly reliable. Some FCM-D cases are PCNSLs with strong tumor microenvironmental reactions. |
| first_indexed | 2024-03-08T22:32:25Z |
| format | Article |
| id | doaj.art-7ffb17d878e942d88c78a0a02dafcf42 |
| institution | Directory Open Access Journal |
| issn | 1349-8029 |
| language | English |
| last_indexed | 2024-03-08T22:32:25Z |
| publishDate | 2023-11-01 |
| publisher | The Japan Neurosurgical Society |
| record_format | Article |
| series | Neurologia Medico-Chirurgica |
| spelling | doaj.art-7ffb17d878e942d88c78a0a02dafcf422023-12-18T00:32:42ZengThe Japan Neurosurgical SocietyNeurologia Medico-Chirurgica1349-80292023-11-01631149550210.2176/jns-nmc.2023-00292023-0029Analysis of False-negative Findings of the Incomparable Accuracy and Swiftness of Flow Cytometric Diagnosis of Primary Central Nervous System LymphomaHayato TAKEUCHI0Tohru INABA1Yukiko SHISHIDO-HARA2Taku TSUKAMOTO3Shinsuke MIZUTANI4Takanari OKAMOTO5Seisuke TANIGAWA6Takumi YAMANAKA7Yoshinobu TAKAHASHI8Eiichi KONISHI9Junya KURODA10Naoya HASHIMOTO11Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medical ScienceDepartment of Infection Control & Laboratory Medicine, Kyoto Prefectural University Graduate School of Medical ScienceDepartment of Pathology and Applied Neurobiology, Kyoto Prefectural University Graduate School of Medical ScienceDivision of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University Graduate School of Medical ScienceDivision of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University Graduate School of Medical ScienceDepartment of Neurosurgery, Kyoto Prefectural University Graduate School of Medical ScienceDepartment of Neurosurgery, Kyoto Prefectural University Graduate School of Medical ScienceDepartment of Neurosurgery, Kyoto Prefectural University Graduate School of Medical ScienceDepartment of Neurosurgery, Kyoto Prefectural University Graduate School of Medical ScienceDepartment of Pathology, Kyoto Prefectural University Graduate School of Medical ScienceDivision of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University Graduate School of Medical ScienceDepartment of Neurosurgery, Kyoto Prefectural University Graduate School of Medical SciencePrimary central nervous system lymphoma (PCNSL), a relatively rare brain tumor, bears a dire prognosis. On occasion, the 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. This study aimed to reveal the utility of FCM diagnosis for PCNSL and the cause of false-negative results of FCM diagnosis. We investigated 33 patients with suspected PCNSL on neuroradiological findings and received both FCM and histological diagnosis. The patients' electronic medical records were investigated, and histological findings, results of FCM, and other clinical data were evaluated. Overall, 27 patients (14 males and 13 females) were diagnosed with PCNSL by histological confirmation. The median age at diagnosis was 68 years. FCM analysis showed lymphoma pattern in 24 cases; however, FCM results did not show lymphoma pattern (sensitivity: 88.9%, specificity: 100%) in the other three lymphoma cases (FCM discordant: FCM-D) and six nonlymphomatous tumor cases. Analysis of FCM-D cases showed the infiltration of T lymphocytes or astrocytes into the tumor tissue, indicating tumor microenvironmental reaction; it is assumed that these reactions deceived FCM diagnosis. The survival of FCM-D patients was superior to FCM concordant counterpart, although the difference was not significant (p = 0.459). The diagnosis of PCNSL by FCM is rapid and highly reliable. Some FCM-D cases are PCNSLs with strong tumor microenvironmental reactions.https://www.jstage.jst.go.jp/article/nmc/63/11/63_2023-0029/_pdf/-char/enprimary central nervous system lymphomaflow cytometrydiagnosistumor microenvironmenttumor-infiltrating lymphocyte |
| spellingShingle | Hayato TAKEUCHI Tohru INABA Yukiko SHISHIDO-HARA Taku TSUKAMOTO Shinsuke MIZUTANI Takanari OKAMOTO Seisuke TANIGAWA Takumi YAMANAKA Yoshinobu TAKAHASHI Eiichi KONISHI Junya KURODA Naoya HASHIMOTO Analysis of False-negative Findings of the Incomparable Accuracy and Swiftness of Flow Cytometric Diagnosis of Primary Central Nervous System Lymphoma Neurologia Medico-Chirurgica primary central nervous system lymphoma flow cytometry diagnosis tumor microenvironment tumor-infiltrating lymphocyte |
| title | Analysis of False-negative Findings of the Incomparable Accuracy and Swiftness of Flow Cytometric Diagnosis of Primary Central Nervous System Lymphoma |
| title_full | Analysis of False-negative Findings of the Incomparable Accuracy and Swiftness of Flow Cytometric Diagnosis of Primary Central Nervous System Lymphoma |
| title_fullStr | Analysis of False-negative Findings of the Incomparable Accuracy and Swiftness of Flow Cytometric Diagnosis of Primary Central Nervous System Lymphoma |
| title_full_unstemmed | Analysis of False-negative Findings of the Incomparable Accuracy and Swiftness of Flow Cytometric Diagnosis of Primary Central Nervous System Lymphoma |
| title_short | Analysis of False-negative Findings of the Incomparable Accuracy and Swiftness of Flow Cytometric Diagnosis of Primary Central Nervous System Lymphoma |
| title_sort | analysis of false negative findings of the incomparable accuracy and swiftness of flow cytometric diagnosis of primary central nervous system lymphoma |
| topic | primary central nervous system lymphoma flow cytometry diagnosis tumor microenvironment tumor-infiltrating lymphocyte |
| url | https://www.jstage.jst.go.jp/article/nmc/63/11/63_2023-0029/_pdf/-char/en |
| work_keys_str_mv | AT hayatotakeuchi analysisoffalsenegativefindingsoftheincomparableaccuracyandswiftnessofflowcytometricdiagnosisofprimarycentralnervoussystemlymphoma AT tohruinaba analysisoffalsenegativefindingsoftheincomparableaccuracyandswiftnessofflowcytometricdiagnosisofprimarycentralnervoussystemlymphoma AT yukikoshishidohara analysisoffalsenegativefindingsoftheincomparableaccuracyandswiftnessofflowcytometricdiagnosisofprimarycentralnervoussystemlymphoma AT takutsukamoto analysisoffalsenegativefindingsoftheincomparableaccuracyandswiftnessofflowcytometricdiagnosisofprimarycentralnervoussystemlymphoma AT shinsukemizutani analysisoffalsenegativefindingsoftheincomparableaccuracyandswiftnessofflowcytometricdiagnosisofprimarycentralnervoussystemlymphoma AT takanariokamoto analysisoffalsenegativefindingsoftheincomparableaccuracyandswiftnessofflowcytometricdiagnosisofprimarycentralnervoussystemlymphoma AT seisuketanigawa analysisoffalsenegativefindingsoftheincomparableaccuracyandswiftnessofflowcytometricdiagnosisofprimarycentralnervoussystemlymphoma AT takumiyamanaka analysisoffalsenegativefindingsoftheincomparableaccuracyandswiftnessofflowcytometricdiagnosisofprimarycentralnervoussystemlymphoma AT yoshinobutakahashi analysisoffalsenegativefindingsoftheincomparableaccuracyandswiftnessofflowcytometricdiagnosisofprimarycentralnervoussystemlymphoma AT eiichikonishi analysisoffalsenegativefindingsoftheincomparableaccuracyandswiftnessofflowcytometricdiagnosisofprimarycentralnervoussystemlymphoma AT junyakuroda analysisoffalsenegativefindingsoftheincomparableaccuracyandswiftnessofflowcytometricdiagnosisofprimarycentralnervoussystemlymphoma AT naoyahashimoto analysisoffalsenegativefindingsoftheincomparableaccuracyandswiftnessofflowcytometricdiagnosisofprimarycentralnervoussystemlymphoma |