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.

Flow Cytometry Submission Video

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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