Immunophenotype outliers with benign diagnosis and negative for lymphoma on follow-up: histological and clinical features
| Reactive pattern/diagnosis | IS TRA | AI INF | F/U (years) | F/U LYM | |||||||
| Neg | RFH | FL | PTGC | PH | DL | Other | |||||
| Kappa:lambda ratio >3:1 or <1:1 | |||||||||||
| Lymphocyte K:L <1:1 Gate K:L >3:1 | 4 | 1 | 1 | 1 | SD (n=1) | 2 | 2 | 4.2 (1–7) | – | ||
| Large cell K:L <1:1 Gate K:L >3:1 | 1 | 11 | 1 | 1 | AH (n=1), KD (n=1), CD (n=1), GL/IFXN (n=2) | 3 | 5 | 2.8 (1 month–12 years) | – | ||
| CD10/19 outliers* | |||||||||||
| Lymphocyte gate | 5 | 2 | HIV-LA (n=2) | 4 | 1 | 3.6 (2–6) | – | ||||
| Large cell gate | 5 | 1 | 1 | HIV-LA (n=1) | 3 | 2 | 4.8 (2–7) | – | |||
| CD5/19 outliers* | |||||||||||
| Lymphocyte gate | 4 | 1 | 2 | 4.2 (1–9) | – | ||||||
| Large cell gate | 2 | 3 | SD (n=1) | 1 | 2 | 4 (1–8) | – | ||||
| CD4:CD8 >10:1/<1:1 | |||||||||||
| CD4:CD8 <1:1 (lowest 10) | 3 | 2 | 2 | 1 | KD (n=2), CD (n=1), GL (n=1), HIV-LA (n=1) | 5 | 4 | 3.3 (2 months–9 years) | – | ||
| CD4:CD8 >10:1 (top 10) | 2 | 6 | SD (n=1) | 7 | 2 | 4.6 (1–8) | – | ||||
| CD7 loss outliers* | |||||||||||
| 1 | 6 | 1 | 1 | 2 | LG (n=1), HIV-LA (n=1) | 5 | 4 | 2.5 (4 months–7 years) | – | ||
*Outlier defined as greater than 1.5 times the IQR above the third quartile. One overlapping case between kappa:lambda and CD10, one between kappa:lambda and CD5, one between kappa:lambda lymphocyte gate (LG) and large cell gate (LCG).
Clinical acronyms: AI INF, autoimmune or inflammatory disease; F/U LYM, subsequent lymphoma on follow-up; F/U (years), duration of follow-up in years; INFL, inflammatory condition; IS TRA, immunosuppressed or (solid organ or marrow) transplant.
Diagnosis/Pattern acronyms: AH, angiomyomatous hamartoma; CD, Castleman disease; DL, dermatopathic lymphadenopathy; FL, follicular lysis; GL, granulomatous lymphadenitis; HIV-LA, HIV lymphadenitis; IFXN, infectious lymphadenitis; KD, Kikuchi disease; LG, lipogranulomatosis; Neg, negative; PH, paracortical hyperplasia; PTGC, progressive transformation of germinal centres; RFH, reactive follicular hyperplasia; SD, sarcoidosis.