A complex diagnostic approach in lymphomas: practical aspect in short case reports

Česká verze

Authors: Markéta Kalinová; Marcela Mrhalová; Lenka Krsková; Helena Jungbauerová; Alena Kalfusová; Petra Manďáková; Jarmila Čandová; Jan Soukup; Vít Campr; Roman Kodet
Authors place of work: Lymfomová skupina, Ústav patologie a molekulární medicíny 2. LF UK a FN v Motole, Praha
Published in the journal: Čes.-slov. Patol., 50, 2014, No. 3, p. 118-126
Category: Přehledový článek

Summary

Complex laboratory investigation is necessary for the diagnosis and relevant classification of lymphomas. The classical histopathological morphology and cytology investigation is essential, but further investigations such as immunohistochemistry and fluorescence in situ hybridization are necessary. It is also important to employ flow cytometry as a method of investigation running synchronously or preceding the histopathological approach. Last but not least, the investigation of nucleic acids in lymphoma by molecular approaches is necessary and has become an everyday practice. Communication between pathologists and clinical colleagues (oncologists, hematologists, internal medicine specialists and radiologists) is very important. We demonstrate the necessity of a complex diagnostic approach to lymphomas and an appropriate interpretation of all laboratory investigations giving examples of eight patients with various types of lymphomas. In some cases, it is impossible to properly diagnose a lymphoma without molecular investigation. Occasionally, the results of the molecular investigation may be misleading and/or may be inaccurately interpreted, leading to an incorrect conclusion. For that reason, it is very important to incorporate all specialized laboratories and their teams under one roof (preferably that of pathology departments), enabling tight and daily cooperation between the specialists. This is the way to reach a precise diagnosis in a majority of cases, as well as how to comply with clinical expectations of properly classified lymphomas for a targeted therapy of patients.

Keywords:
lymphoma – immunohistochemistry – FISH – flow cytometry – PCR – complex diagnosis

Zdroje

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