Clinical possibilities of flow cytometry in hodgkin’s lymphoma

   Hodgkin’s lymphoma (HL) is a unique lymphoma of b-cell origin, the tumor cells of which have lost the expression of main b-cell antigens. The standard immunophenotype of the tumor substrate, according to immunohistochemical studies, is characterized by the expression of such markers as CD15, CD30 and PAX-5, while tumor cells have a negative expression of CD3, CD19 and in most cases also CD20 and CD45 (or express this antigen rather weakly). The knowledge gained in recent years has increased the effectiveness of diagnosis, prognosis and treatment of LH. Flow cytometry, as a method of immunophenotyping in classical LH, was practically not used due to the difficulty of distinguishing single reed–sternberg–berezovsky tumor cells (RSB) and the tumor microenvironment (reactive background), which is very rich in cellular elements and is represented by T cells, B cells, eosinophils, histiocytes and plasma cells. However, in the recent past, several studies have successfully attempted to identify rsb cells using multiparameter flow cytometry during aspiration with a thin needle or biopsy of lymph node tissue to confirm or supplement immunohistochemical staining during primary diagnosis. Taking into account the very characteristic immunophenotype of RSB cells, the flow cytometry may become an additional diagnostic method of classical LH in the future. In this review, we summarize the data on the possibility of using the flow cytometry as an additional clinical diagnostic option in the primary diagnosis of classical LH.

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