Diagnostic Utility of Performing Flow Cytometry on Provider-Submitted Endoscopically Collected Gastrointestinal Samples

Abstract

Multicolor flow cytometry (MFC) is essential to the diagnosis of non-Hodgkin lymphoma (NHL). In our institution, MFC specimens are submitted by pathologists or an ordering provider. As endoscopy has revolutionized the ability to biopsy the gastrointestinal (GI) tract, our lab increasingly receives provider-submitted, endoscopically-acquired GI biopsies (PEGIB) for MFC analysis. This study evaluates the clinical utility of MFC performed on PEGIB and proposes a new testing algorithm to enhance the pathology team’s role in MFC test utilization. Fifty-five archival PEGIB MFC cases were identified and histories were reviewed. MFC was non-contributory to the overall diagnosis in 85% of PEGIB. Retroactively implementing an algorithm that used PEGIB permanent section screening to triage the 55 archival cases resulted in the appropriate identification of 100% of specimens whose diagnosis would have benefitted from MFC analysis, and the optimization of test utilization by decreasing unnecessary MFC studies.