Aims To create clinically relevant normative flow cytometry data for understudied benign lymph nodes and characterise outliers.
Methods Clinical, histological and flow cytometry data were collected and distributions summarised for 380 benign lymph node excisional biopsies. Outliers for kappa:lambda light chain ratio, CD10:CD19 coexpression, CD5:CD19 coexpression, CD4:CD8 ratios and CD7 loss were summarised for histological pattern, concomitant diseases and follow-up course.
Results We generated the largest data set of benign lymph node immunophenotypes by an order of magnitude. B and T cell antigen outliers often had background immunosuppression or inflammatory disease but did not subsequently develop lymphoma.
Conclusions Diagnostic immunophenotyping data from benign lymph nodes provide normative ranges for clinical use. Outliers raising suspicion for B or T cell lymphoma are not infrequent (26% of benign lymph nodes). Caution is indicated when interpreting outliers in the absence of excisional biopsy or clinical history, particularly in patients with concomitant immunosuppression or inflammatory disease.
- lymph node
- flow cytometry
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Handling editor Mary Frances McMullin.
Contributors GDS and DG planned the study. GDS performed data collection, software programming and analysis. GDS, DG, and SA conducted data interpretation, critical review and drafting of the manuscript.
Competing interests None declared.
Ethics approval Stanford University Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Raw flow event data will be made available by email request at the discretion of the corresponding author.
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