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What does my cytometry test report indicate?

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Posted on Wed, 25 Oct 2017
Question: Hello,

I recently had flow cytometry test done on Peripheral blood. Reason for the test was mildly elevated relative lymphocyte count. The Absolute count was fine. Below is the report of the Flow cytometry. I would like to have it reviewed by a Hematologist.

Also I would like to know what does the following line mean: "Monocytes co-express CD14 and CD64 without phenotypic abnormalities.". Are CD14 and CD64 normally expressed in monocytes?

Report is here:
F Flow Cytometry Interpretation See Below For Report
- Peripheral Blood
- Diagnosis:
- No diagnostic immunophenotypic abnormalities detected (see comments).
- Comments:
- No immunophenotypic evidence of a lymphoproliferative disorder, acute leukemia or circulating
- blasts is identified. Myeloproliferative neoplasms and myelodysplastic syndromes may not show
- antigenic abnormalities on myeloid cells and cannot be ruled out by flow cytometry. Please
- correlate the result with morphological findings, other pertinent laboratory data and clinical information.
- Flow Differential (%) and Population Analysis:
- Lymphocytes: 39.6%
- T-cells (71% of lymphoid cells) show a CD4/CD8 ratio of about 1.2 without overt
- phenotypic abnormality. NK-cells (11% of lymphoid cells) are unremarkable. Mature B-cells (15% of
- lymphoid cells) are polyclonal (kappa:lambda 1.6).
- Monocytes: 5.1%
- Monocytes co-express CD14 and CD64 without phenotypic abnormalities.
- Granulocytes: 51.7%
- Granulocytes are phenotypically mature and without aberrant antigen expression.
- Specimen Viability: 99.7%
- Cell Yield: 4.2 Million
- Markers Performed:
- CD2, CD3, CD4, CD5, CD7, CD8, CD10, CD11c, CD13, CD14, CD16, CD19, CD20,
- CD23, CD33, CD34, CD38, CD45, CD56, CD64, CD117, HLA-DR, Kappa, Lambda (24 Markers)
- Interpreted by Lija XXXXXXX MD, Medical Director
- These tests were developed and the performance characteristics
- determined by NeoGenomics. They have not been cleared or approved by the US Food and Drug
- Administration (FDA). The FDA has determined that such clearance or approval is not necessary. These tests
- are used for clinical purposes. Prognostic and predictive testing should be interpreted in the
- context of additional clinical and/or histopathological findings.
- Technical component performed by NeoGenomics, 31 XXXXXXX Aliso Viejo, CA 92656.
doctor
Answered by Dr. Deepak Sundriyal (2 hours later)
Brief Answer:
Hello. The flowcytometry report is normal

Detailed Answer:
Hello dear. I have seen the blood counts reports as well as flowcytometric analysis. First of all, your lymphocyte counts were marginally elevated and we take this as normal in clinical practice.
This is due to variable rates of production and destruction of lymphocytes , that these counts may spill on either side of normal range.

Also, any occult viral infection can lead to slight increase in lymphocytes counts.


Now coming to flowcytometry. This report is normal. CD 14 and 64 are cluster antigens found on monocytes cells and normally expressed. There is nothing abnormal about it.
Phenotype refers to the abnormality in the size or shape of cell, or abnormality in its internal structure. If such abnormality is identified, it points towards some infection or blood cancer.
You have normal phenotypic characteristics and thus no disease.
Hope you understand now.
thanks and regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Deepak Sundriyal (6 hours later)
Thank you Dr XXXXXXX I am an anxiety disorder patient and tend to over analyze the results. So your answer helps a lot. One followup question. Does this flow cytometry test also detect Multiple Myleoma? I'm not sure why i'm fixated with that.

I understand that the B cells looked normal and polyclonal, which is a good indication. But still a confirmation from an expert like you help.

Thank you,

Kartik
doctor
Answered by Dr. Deepak Sundriyal (3 hours later)
Brief Answer:
Hello. No it doesnt detect myeloma

Detailed Answer:
Hello again . So we dont do a flow test for diagnosing myeloma. Moreover, your blood counts do not suggest myeloma also and there is no need to worry.
Thanks and regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Deepak Sundriyal (15 hours later)
Thank you Dr XXXXXXX for your response. I have two followup questions if you dont mind (for sake of my peace of mind).

1) I understand flow cytometry would not be used to diagnose myeloma. But would it show some abnormalities if there was myeloma? The flow cytometry report mentions "Mature B-Cells which are polyclonal" and the "kappa:lambda 1.6". I have read on the internet that in cases of myeloma these will not be the case. Is that correct? Also my doctor had done eGFR and metabolic panel tests (including albumin) and all those reports came back fine.

2) Also you said my blood count does not indicate myeloma. Does that mean in case of myeloma, the WBC/RBC counts are way higher of way lower?

Sorry for the barrage of questions even after you said everything is normal and there is no need to worry. Unfortunately have partial information from the internet which stokes my anxiety. Your response would be helpful.

Thanks,

Kartik
doctor
Answered by Dr. Deepak Sundriyal (8 hours later)
Brief Answer:
Hello. Flow cant assess kappa lambda ratio

Detailed Answer:
Hello. I would like to clear 2 points. First of all kappa lambda ratio is accurately determined by serum free light chain assay test and not by flow. Moreover, there is no evidence of myeloma on flow as well.
Wbc and rbc counts have nothing to do with myeloma. There is immature population of plasma cells which gets increased in myeloma along with abnormal protein in blood.
Just relax and dont go to google as it will increase your anxiety unnecessarily.
You can ask any further question any number of times but dnt get panicked by search on google.
Thanks and regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Deepak Sundriyal (12 hours later)
Thank you Dr XXXXXXX That was helpful. I realize its my anxiety which makes me overthink all these. Thanks for your patience.
doctor
Answered by Dr. Deepak Sundriyal (1 minute later)
Brief Answer:
Welcome

Detailed Answer:
Thanks and regards
feel free to ask further
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. Deepak Sundriyal

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What does my cytometry test report indicate?

Brief Answer: Hello. The flowcytometry report is normal Detailed Answer: Hello dear. I have seen the blood counts reports as well as flowcytometric analysis. First of all, your lymphocyte counts were marginally elevated and we take this as normal in clinical practice. This is due to variable rates of production and destruction of lymphocytes , that these counts may spill on either side of normal range. Also, any occult viral infection can lead to slight increase in lymphocytes counts. Now coming to flowcytometry. This report is normal. CD 14 and 64 are cluster antigens found on monocytes cells and normally expressed. There is nothing abnormal about it. Phenotype refers to the abnormality in the size or shape of cell, or abnormality in its internal structure. If such abnormality is identified, it points towards some infection or blood cancer. You have normal phenotypic characteristics and thus no disease. Hope you understand now. thanks and regards