Clinical Flow Cytometry

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We utilize flow cytometry to determine the immunophenotype of cells by recognizing normal and abnormal expression of cell surface markers on T cells (helper T cells, cytotoxic T cells), B cells, neutrophils and monocytes. Flow cytometry is available for dogs and cats.

Clinical flow cytometry is most often used:

  • To help distinguish between reactive and neoplastic lymphocytes
  • To determine if lymphoma/leukemia is of B or T cell origin and in some cases, identify specific subtypes of B or T cell lymphoma/leukemia which will aid in prognosis
  • To differentiate between lymphoid and non-lymphoid (myeloid/monocytic) neoplasia

Clinical flow cytometry is used most often in combination with clinical history/presentation and cytology/blood smear examination for diagnosis of disease. In some cases, additional diagnostics (PARR- PCR for antigen receptor rearrangement, histopathology, immunohistochemistry, immunocytochemistry) are also required.

When might clinical flow cytometry be most helpful?

Lymphadenopathy, organomegaly, or mediastinal mass with the following cytology results:

  • Confirmed or probable lymphoma composed of intermediate to large lymphocytes
  • Homogeneous expansion of small to intermediate lymphocytes
  • Suspected lymphoma or thymoma (for mediastinal mass)

Sample to submit: Fine needle aspirate of lymph node/enlarged organ/mass (see sample submission guidelines)

Note: Flow cytometry is not indicated on these samples if cytology results report rare to low numbers of atypical/suspicious cells

Abnormal CBC findings consisting of:

  • Peripheral lymphocytosis with increased numbers of small mature, intermediate, or immature lymphocytes
  • Presence of any immature cells/’blasts’ with a normal or elevated white blood cell count

Sample to submit: Peripheral blood (EDTA tube)

NOTE: If the lymphocytosis is composed of small to intermediate lymphocytes test for Ehrlichia infection in dogs with lymphocyte counts up to ~50k and ‘stress’ in cats with lymphocyte counts up to ~30k prior to running flow cytometry

Abnormal bone marrow findings with the following cytology/CBC results:

  • Increased numbers of blasts or small/intermediate lymphocytes with leukopenia on CBC

Sample to submit: Bone marrow (EDTA tube) for samples with leukopenia on CBC. Peripheral blood (EDTA tube) is preferred if lymphocytosis is present.

Body cavity effusion with the following cytology results:

  • High numbers of small/intermediate/OR large lymphocytes consistent with or concerning for lymphoma

Sample to submit: Cavity fluid (EDTA tube and red top tube when possible- 0.5ml in each tube (see sample submission guidelines)

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