Anaplastic large cell lymphoma: A flow cytometric analysis of 29 cases

We report our experience with flow cytometric (FC) analysis of 29 cases of anaplastic large cell lymphoma (ALCL). Morphologic analysis of processed cytocentrifuged preparations demonstrated neoplastic cells in 28 cases. In 25 of these, an aberrant lymphoid population was detected by FC analysis. The majority showed high orthogonal light scatter, similar to monocytes or granulocytes. Of the antigens CD2, CD3, CD4, CD5, and CD7, 5 cases expressed 1, 8 expressed 2, 6 expressed 3, 3 expressed 4, and 3 expressed all 5. CD4 was expressed most commonly (20/25 [80%]), followed by CD2 (18/25 [72%]), CD3 (10/25 [40%]), and CD5 and CD7 (8/25 [32%] each). CD45 was expressed in 23 of 25 cases and CD13 in 7 of 9. Of 21 cases, 13 were anaplastic lymphoma kinase (ALK)+, all of which were CD4+, vs 5 of 8 ALK– cases (P = .042). Most ALCLs can be detected and characterized by multiparameter FC analysis. However, light scatter gating on typical lymphoid regions may yield falsenegative results in a substantial number of cases. Systemic anaplastic large cell lymphoma (ALCL) accounts for 3% of adult non-Hodgkin lymphomas (NHLs) and 10% to 30% of childhood NHLs and, in general, is associated with a good response to therapy and a favorable outcome. Approximately 60% of ALCLs carry a translocation involving the anaplastic lymphoma kinase (ALK) gene on chromosome 2p23, most commonly a t(2;5)(p23;q35) involv