Abstracts/Presentation Description
Clara Macindoe1, Charlie Roache2, Brigitte Papa1, Beena Kumar1,2,Samar Ojaimi1,2
1Monash Health Pathology, Monash Health, Clayton, Australia
2Monash University, Clayton, Australia
Introduction:
Tonsillar tissue is frequently sent for flow cytometric analysis for exclusion of haematological malignancies, often without clear clinical indication. The lack of definitive guidelines for handling tonsillar specimens may lead to inefficient use of flow cytometry. This audit assesses the diagnostic yield of routine flow cytometry on tonsillar tissue, to inform more efficient resource utilization.
Tonsillar tissue is frequently sent for flow cytometric analysis for exclusion of haematological malignancies, often without clear clinical indication. The lack of definitive guidelines for handling tonsillar specimens may lead to inefficient use of flow cytometry. This audit assesses the diagnostic yield of routine flow cytometry on tonsillar tissue, to inform more efficient resource utilization.
Methods:
Data were collected from 165 patients over two years for all samples sent for histological assessment. Specimens submitted for flow cytometry were further analysed based on clinical history, histology findings, and flow cytometric results.
Data were collected from 165 patients over two years for all samples sent for histological assessment. Specimens submitted for flow cytometry were further analysed based on clinical history, histology findings, and flow cytometric results.
Results:
The median patient age was 48 (1-87) years, with a predominance of male patients (57.6%). Among 417 specimens, flow cytometry was requested for 142. Of these, only 7.7% of tonsillar specimens with suspected haematological malignancy showed monoclonal populations. No monoclonal populations were detected in cases with suspected solid malignancy or tonsillar asymmetry. Tonsillar histopathology diagnosis correlated with flow cytometry 96.1% of the time.
The median patient age was 48 (1-87) years, with a predominance of male patients (57.6%). Among 417 specimens, flow cytometry was requested for 142. Of these, only 7.7% of tonsillar specimens with suspected haematological malignancy showed monoclonal populations. No monoclonal populations were detected in cases with suspected solid malignancy or tonsillar asymmetry. Tonsillar histopathology diagnosis correlated with flow cytometry 96.1% of the time.
Discussion:
This audit suggests that routine flow cytometry for tonsillar specimens has limited diagnostic value except in suspected haematological malignancies. Histopathology alone is often adequate, supporting a rationalized approach to reduce unnecessary flow cytometry requests, thereby conserving resources. Future analysis will evaluate the economic and environmental impacts of these findings.
Author contributions:
Clara Macindoe - Data collection, statistical analysis, write up
Charlie Roache - Data collection and statistical analysis
Brigitte Papa - Data collection
Been Kumar - Program Director of Pathology, Monash Health
Samar Ojaimi - Project lead and head of Immunopathology, Monash Health
This audit suggests that routine flow cytometry for tonsillar specimens has limited diagnostic value except in suspected haematological malignancies. Histopathology alone is often adequate, supporting a rationalized approach to reduce unnecessary flow cytometry requests, thereby conserving resources. Future analysis will evaluate the economic and environmental impacts of these findings.
Author contributions:
Clara Macindoe - Data collection, statistical analysis, write up
Charlie Roache - Data collection and statistical analysis
Brigitte Papa - Data collection
Been Kumar - Program Director of Pathology, Monash Health
Samar Ojaimi - Project lead and head of Immunopathology, Monash Health