Utility of routine flow cytometric analysis on tonsillar tissue.

Abstract

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 utilisation. Method(s): 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. Result(s): 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(s): 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 rationalised approach to reduce unnecessary flow cytometry requests, thereby conserving resources. Future analysis will evaluate the economic and environmental impacts of these findings.Copyright © 2024