This fourth edition presents an updated and expanded text and illustrations to reflect continued morphologic, immunophenotypic, and especially molecular advances in the field of neoplastic hematology, mostly due to the rapidly expanding application of next-generation sequencing. Those advances not only allow a more reliable diagnosis of the majority of tumors and identification of early changes such as monoclonal B-cell lymphocytosis or clonal hematopoiesis of indeterminate potential (CHIP), but also in many cases identify mutations or phenotypic changes in tumors that can be targeted by mutation-specific or antigen-specific drugs.
This edition incorporates the updated WHO classification of hematopoietic tumors and new immunophenotypic and molecular markers to provide a thorough pathologic overview of hematologic neoplasms while focusing on flow cytometric features. Special emphasis has been put on hematological neoplasms with crucial clinical significance such as acute promyelocytic leukemia, other acute leukemias, and difficult areas in flow cytometry. Flow cytometric features in AML, MDS, CMML, CLL and measurable residual disease were significantly expanded. There are many new comparative tables, illustrations, and diagrams of algorithmic approaches.
Author(s): Wojciech Gorczyca
Edition: 4
Publisher: CRC Press
Year: 2022
Language: English
Pages: 730
City: Boca Raton
Cover
Half Title
Title Page
Copyright Page
Dedication
Contents
Preface
Abbreviations
1. Introduction to Flow Cytometry
The major roles of flow cytometry
Flow cytometry in hematological emergencies
10-color flow cytometry analysis
Automated flow cytometry data analysis
Flow cytometry parameters
Limitations of flow cytometry
Classification of hematopoietic neoplasms
2. Flow Cytometry Analysis of Blood and Bone Marrow
Bone marrow: Normal structure and hematopoiesis
Antigen expression during hematopoietic maturation
Flow cytometry of blood and bone marrow: Gating strategies
Blood: Normal flow cytometry pattern
Bone marrow: Normal flow cytometry pattern
3. Identification of Clonal B-Cell Population
Polyclonal versus monoclonal B-cells
Monoclonal B-cell lymphocytosis
B-cells versus plasma cells
Mature versus immature B-cells
4. Identification of Abnormal T-Cell Population
Introduction
Aberrant T-cell phenotype by flow cytometry
Lack of CD45 or very dim CD45 expression
Presence of additional markers
Peripheral (mature) disorders versus T-ALL
T-cell markers expressed by non-T-cell processes
5. Identification of Myeloblasts
Introduction
Identification of myeloblasts by flow cytometry
Flow cytometric pattern in major AML subtypes
Leukemia-associated immunophenotype (LAIP)
Differential diagnosis of AML based on flow cytometry pattern
6. Identification of Lymphoblasts
Identification of B-lymphoblasts
Identification of T-lymphoblasts
7. Immunophenotypic Markers in Flow Cytometry
BCL2 (B-cell lymphoma/leukemia 2)
CD1a (cluster of differentiation 1a)
CD2
CD3
CD4 and CD8
CD5
CD7
CD10
CD11b
CD11c
CD13 and CD33
CD14
CD15
CD16
CD19
CD20
CD22
CD23
CD24
CD25
CD26
CD27
CD30
CD34
CD36
CD38
CD43
CD45
CD49d
CD52
CD56
CD57
CD64
CD65
CD71 (transferrin receptor)
CD79
CD81
CD103
CD117 (c-Kit)
CD123
CD133
CD138
CD157
CD200
CD235a/GPHA (glycophorin A)
FLAER
HLA-DR (human leukocyte antigen-DR isotype)
LILRB1 (leukocyte immunoglobulin-like receptor B1)
TCR beta F1 (T-cell receptor beta F1)
TCR gamma/delta
TdT (terminal deoxynucleotidyl transferase)
8. Morphologic-Flow Cytometric Correlation in Blood
Normal blood
Pancytopenia/cytopenia
Neutrophilia
Eosinophilia
Lymphocytosis
Erythrocytosis/polycythemia
Basophilia
Thrombocytosis
Circulating blasts
Monocytosis
Leukoerythroblastosis
Circulating plasma cells
9. Morphologic-Flow Cytometric Correlation in Bone Marrow
Benign bone marrow
Increased blasts
Diffuse small cell infiltrate
Diffuse intermediate/large cell infiltrate
Diffuse blastoid (“high-grade”) infiltrate
Increased number of scattered large cells (other than megakaryocytes)
Paratrabecular lymphoid infiltrate
Intrasinusoidal infiltrate
Lymphoid aggregates (nodular lymphoid infiltrate)
Pleomorphic lymphoid infiltrate
Megakaryocytosis
Eosinophilia
Erythroid hyperplasia with dyserythropoiesis
Marrow infiltrate with fibrosis
Plasmacytosis
Metastatic tumors and other infiltrative processes
10. Morphologic-Flow Cytometric Correlation in Lymph Nodes
Reactive follicular hyperplasia
Diffuse pattern with mostly small cells
Diffuse pattern with medium-sized and/or large cells
Mixed (pleomorphic) infiltrate
Blastoid and/or “high-grade” infiltrate
Nodular pattern
Paracortical (interfollicular; T-zone) pattern
Intrasinusoidal pattern
Anaplastic infiltrate
Histiocyte-rich infiltrate
11. Molecular-Flow Cytometric Correlation
Introduction – Overview of genetic testing
Molecular-flow cytometric correlation
12. Phenotypic Classification of Mature B-Cell Neoplasms
Introduction
Classification of B-cell neoplasms based on CD5 and CD10 expression
Additional phenotypic markers in B-cell neoplasms
Classification of B-cell neoplasms based on forward scatter (grading)
B-cell neoplasms with plasmacytic differentiation
13. Mature B-Cell Lymphoproliferations
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)
B-cell prolymphocytic leukemia (B-PLL)/splenic B-cell lymphoma/leukemia with prominent nucleoli (SBLPN)
Nodal marginal zone lymphoma (MZL)
Gastric MZL (MALT lymphoma)
Splenic marginal zone lymphoma (SMZL)
Marginal zone lymphoma with blood and/or BM involvement
Splenic B-cell lymphoma/leukemia with prominent nucleoli/hairy cell leukemia variant (SBLPN/HCL-v)
Hairy cell leukemia (HCL)
Splenic diffuse red pulp small B-cell lymphoma (SDRPL)
Lymphoplasmacytic lymphoma (LPL)
Follicular lymphoma
Mantle cell lymphoma (MCL)
Diffuse large B-cell lymphoma (DLBCL)
Specific variants of DLBCL
Burkitt lymphoma (BL)
High-grade B-cell lymphomas
Plasmablastic lymphoma (PBL)
Primary effusion lymphoma (PEL)
14. Plasma Cell Neoplasms
Plasma cell myeloma (PCM)
Introduction
Morphology
Immunohistochemistry
Flow cytometry
Measurable (minimal) residual disease (MRD)
Differential diagnosis of PCM
Plasmacytoma
Monoclonal gammopathy of undetermined significance
Plasma cell leukemia
15. Phenotypic Classification of Mature T/NK-Cell Lymphoproliferations
Introduction
Nodal T-cell lymphomas with CD10 expression (T-cell lymphomas with T follicular helper phenotype)
T-cell lymphoproliferations with CD30 expression
T-cell lymphoproliferations with CD25 expression
T-cell lymphoproliferations with CD56 expression
Additional phenotypic markers in T-cell lymphoproliferations
16. Mature T/NK-Cell Lymphoproliferative Disorders
T-cell prolymphocytic leukemia (T-PLL)
Adult T-cell lymphoma/leukemia (ATLL)
T-large granular lymphocyte leukemia (T-LGLL)
Peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS)
Nodal TFH cell lymphoma, angioimmunoblastic-type (AITL)
Anaplastic large cell lymphoma (ALCL)
Aggressive NK-cell leukemia (ANKL)
Extranodal NK/T-cell lymphoma, nasal type (ENKTL)
Enteropathy-associated T-cell lymphoma (EATL)
Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL)
Indolent T-cell lymphoproliferative disorder of the gastrointestinal tract (indolent T-LPD)
Mycosis fungoides (MF)
Sézary’s syndrome (SS)
Hepatosplenic T-cell lymphoma (HSTL)
17. B-Cell Acute Lymphoblastic Leukemia/Lymphoma
Introduction
Morphology
Immunophenotyping
Genetic features
Measurable (minimal) residual disease (MRD) in B-ALL
Differential diagnosis of B-ALL
18. T-Cell Acute Lymphoblastic Leukemia/Lymphoma
Introduction
Morphology
Flow cytometry
Differential diagnosis of T-ALL
Early T-cell precursor T-ALL (ETP-ALL)
19. Myelodysplastic Neoplasms
Introduction
Minimal diagnostic criteria
Morphology
Immunohistochemistry
Flow cytometry
Flow cytometry scoring systems in MDS
Genetic features
Differential diagnosis of MDS
20. Mixed Myelodysplastic-Myeloproliferative Neoplasms
Chronic myelomonocytic leukemia
Juvenile myelomonocytic leukemia
MDS/MPN with SF3B1 mutation and thrombocytosis
MDS/MPN with neutrophilia (MDS/MPN-n)
21. Myeloproliferative Neoplasms
Introduction to myeloproliferative neoplasms
Chronic myeloid leukemia
Polycythemia vera
Essential thrombocythemia
Primary myelofibrosis
Chronic neutrophilic leukemia
Chronic eosinophilic leukemia
22. Acute Myeloid Leukemia, Defined by Differentiation
Acute myeloid leukemia with minimal differentiation
AML without maturation
AML with maturation
Acute myelomonocytic leukemia (AMML)
Acute monoblastic (monocytic) leukemia
Acute erythroid leukemia (AEL)
Acute megakaryoblastic leukemia
Acute panmyelosis with myelofibrosis
Acute basophilic leukemia
Extramedullary myeloid tumor (EMT)
AML with myelodysplasia-related changes (AML-MRC)
Therapy-related myeloid neoplasms
23. Acute Myeloid Leukemia With Defining Genetic Abnormalities
Acute promyelocytic leukemia (APL)
Acute myeloid leukemia with t(8;21) [RUNX1-RUNX1T1]
AML with CBFB-MYH11
AML with MLLT3-MLL
AML with RPN1-EVI1
AML with mutated NPM1
AML with mutated CEBPA
AML with DEK-NUP214
24. Measurable (Minimal) Residual Disease in AML
Introduction
Methods of MRD detection
Leukemia-associated immunophenotype (LAIP)
Flow cytometry analysis of MRD
25. Acute Leukemias of Ambiguous Lineage
Acute undifferentiated leukemia (AUL)
Mixed phenotype acute leukemia
26. Other Neoplasms and PNH
Blastic plasmacytoid dendritic cell neoplasm (BPDCN)
Follicular dendritic cell neoplasms
Histiocytic sarcoma
Langerhans cell histiocytosis
Langerhans cell sarcoma
Metastatic tumors to the bone marrow
Mastocytosis
Simultaneous bi-lineage hematologic malignancies
Paroxysmal nocturnal hemoglobinuria (PNH)
Index
