Flow Cytometry And Immunohistochemistry For Hematologic Neoplasms

Immunophenotyping is the most powerful tool in the routine diagnosis of hematologic neoplasms. Immunohistochemical technique is used in histology labs for this purpose, while flow cytometry is used in clinical labs. Although separately these 2 techniques are very useful in detecting lymphomas and leukemias, the combination of both creates a very powerful and definitive diagnostic tool. The addition of molecular genetics to the book makes it an all-encompassing reference text.

This text is a detailed guide to the use of flow cytometry, immunohistochemistry, and molecular genetic techniques for diagnosis of hematologic neoplasms. Dr. Sun explains the principles of these techniques and demonstrates their utility in 39 clinical cases covering all important entities. Each case represents a comprehensive diagnostic approach including a clinical history and flow cytometric, immunohistochemical, and molecular genetic findings. Abundant full-color illustrations show histologic sections, immunohistochemical stains, bone marrow, peripheral blood, and body fluid smears, and each case includes a complete set of flow cytometric histograms. Over 100 tables compare and differentiate the diagnostic features of similar diseases. An image bank will be available on a companion Website.

Due to its rapid development in recent years, hematopathology has become a very complicated discipline. The current development is mainly in two aspects: the new classification of lymphomas and leukemias and the new techniques. The Revised European-American Classification of Lymphoid Neoplasms (REAL classification) and the World Health Organization (WHO) classification of hematologic neoplasms require not only morphologic criteria but also immunophenotyping and molecular genetics for the diagnosis of hematologic tumors. Immunophenotyping is performed by either flow cytometry or immunohistochemistry. There are many new monoclonal antibodies and new equipments accumulated in recent years that make immunophenotyping more or more accurate and helpful. There are even more new techniques invented in recent years in the field of molecular genetics. In cytogenetics, the conventional karyotype is supplemented and partly replaced by the fluorescence in situ hybridization (FISH) technique. The current development of gene expression profiling is even more powerful in terms of subtyping the hematologic tumors, which may help guiding the treatment and predict the prognosis. In molecular biology, the tedious Southern blotting technique is largely replaced by polymerase chain reaction (PCR). The recent development in reverse-transcriptase PCR and quantitative PCR makes these techniques even more versatile. Because of these new developments, hematopathology has become too complicated to handle by a general pathologist. Many hospitals have to hire a newly trained hematopathologist to oversee peripheral blood, bone marrow and lymph node examinations. These young hematopathologists are geared to the new techniques, but most of them are inexperienced in morphology. No matter how well-trained a hematopathologist is, he or she still needs to see enough cases so that they can recognize the morphology and use the new techniques to substantiate the diagnosis. In other words, morphology is still the basis for the diagnosis of lymphomas and leukemias. Therefore, a good color atlas is the most helpful tool for these young hematopathologists and for the surgical pathologists who may encounter a few cases of hematologic tumors from time to time. In a busy daily practice, it is difficult to refer to a comprehensive hematologic textbook all the time. There are a few hematologic color atlases on the market to show the morphology of the normal blood cells and hematologic tumor cells. These books are helpful but not enough, because tumor cell morphology is variable from case to case and different kinds of tumor cells may look alike and need to be differentiated by other parameters. The best way to learn morphology is through the format of clinical case study. This format is also consistent with the daily practice of hematopathologists and with the pattern in all the specialty board examinations. Therefore, it is a good learning tool for the pathology residents, hematology fellows as well as medical students. This proposed book will present 83 clinical cases with clinical history, morphology of the original specimen and a list of differential diagnoses. This is followed by further testing with pictures to show the test results. At the end, a correct diagnosis is rendered with subsequent brief discussion on how the diagnosis is achieved. A few useful references will be cited and a table will be provided for differential diagnosis in some cases. The major emphasis is the provision of 500 color photos of peripheral blood smears, bone marrow aspirates, core biopsy, lymph node biopsy and biopsies of other solid organs that are involved with lymphomas and leukemias. Pictures of other diagnostic parameters, such as flow cytometric histograms, immunohistochemical stains, cytogenetic karyotypes, fluorescence in situ hybridization and polymerase chain reaction, will also be included. A comprehensive approach with consideration of clinical, morphologic, immunophenotypic and molecular genetic aspects is the best way to achieve a correct diagnosis. After reading this book, the reader will learn to make a diagnosis not only based on the morphology alone but also in conjunction with other parameters.

Flow Cytometry of Hematological Malignancies Flow cytometric analysis is often integral to the swift and accurate diagnosis of leukemias and lymphomas of the blood, bone marrow, and lymph nodes. However, in the fast-moving and expanding field of clinical hematology, in can be challenging to remain up to speed with the latest biological research and technological innovations. Flow Cytometry of Hematological Malignancies has been designed to provide all those working in hematological oncology with a practical, cutting-edge handbook, featuring clear and fully illustrated guidance on all aspects of cytometry’s role in diagnosis and analysis. This essential second edition includes: Explorations of more than 70 antigens Full-color illustrations throughout New descriptions of recently discovered markers WHO classifications of hematological neoplastic diseases Helpful tips for result interpretation and analysis Featuring all this and more, Flow Cytometry of Hematological Malignancies, Second Edition, is an invaluable resource for both trainee and experienced hematologists, hematopathologists, oncologists, and pathologists, as well as medical students and diagnostic lab technicians.

This practical manual offers an active understanding of how to implement flow-cytometry when facing complex, haematological diseases.

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.

This thoroughly updated Second Edition provides a comprehensive review of the basic principles, clinical applications, and interpretation of flow cytometry results. Focusing on hematologic neoplasms, it covers current uses and applications while considering cost containment trends in healthcare. More than 30 complete clinical cases with detailed clinical histories, flow cytometric findings, morphologic illustrations, and other pertinent information on molecular biological techniques, cytochemistry, and cytogenetics provide readers with complete clinical information to assist in diagnosis, as well as to hone skills. The text also features 6 new leukemias/lymphomas and 94 new color illustrations, including color photographs of peripheral blood smears, bone marrow smears, bone marrow core biopsies, and histologic sections of lymph nodes, spleen, liver and solid tumors.

The analysis of blood, bone marrow and tissue fluid specimens requires a multi-faceted approach with the integration of scientific data from a number of disciplines. No single discipline can operate in isolation or errors will occur. Flow cytometry is in a privileged position in that it can provide rapid analysis of specimens and it is often the first definitive investigation to produce results and help formulate a working diagnosis. This companion text to Practical Flow Cytometry in Haematology Diagnosis contains 100 worked examples drawn from real clinical cases presenting to the authors’ institution. Cases are illustrated with peripheral blood and bone marrow cytology, tissue pathology and cytogenetic and molecular data, which are integrated to generate, where appropriate, a diagnosis based on the WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. The spectrum of clinical cases includes adult and paediatric patients, and both neoplastic and reactive disorders. The cases appear in no particular order to challenge the reader to make their own diagnosis. The reader will review May−Grünwald−Giemsa (MGG)-stained films of peripheral blood and bone marrow aspirates presented alongside flow cytometric data and haematoxylin and eosin (H&E)-stained bone marrow and other tissue biopsy sections. Immunohistochemistry is used to further clarify the tissue lineage and cell differentiation. Cytogenetic studies using metaphase preparations are used to identify translocations and chromosome gains and losses whilst interphase fluorescence in situ hybridisation (FISH) studies and polymerase chain reaction (PCR) are used to identify gene fusions, gene rearrangements and deletions. Each case concludes with a discussion of the features that are important to making a diagnosis. The cases are also listed according to disease classification in the appendix so that the text can also be used as a reference. Practical Flow Cytometry in Haematology: 100 Worked Examples: Provides a practical, example-based resource for flow cytometry Demonstrates how flow cytometry results should be interpreted and applied to optimize patient care Includes both malignant and benign conditions Can be used in conjunction with Practical Flow Cytometry in Haematology Diagnosis, by the same author team (ISBN 9780470671207) Practical Flow Cytometry in Haematology: 100 Worked Examples is ideal for practicing haematologists and histopathologists with an interest in haematopathology, but particularly directed at trainee haematologists and scientists preparing for FRCPath and related examinations.