The aggressive malignancy, T-cell lymphoma, has a global annual incidence of >60,000 and rising. T-cell lymphoma can cause masses, fevers, sweats, weight loss, skin rashes, anaemia, bleeding, opportunistic infections and ultimately death. T-cell lymphoma is more difficult to diagnose than B-cell lymphoma, frequently requiring expensive, complex and time-consuming clonality studies. Analysis of B cells in histological material is significantly assisted by the existence of the kappa/ lambda immunohistochemical and in situ hybridisation assays to assess monotypia. Studies indicate that there are significant, often prolonged delays in the diagnosis of T-cell lymphoma. However, the T-cell receptor (TCR) has two alternatively used, but very similar, constant regions, providing the opportunity to make a kappa/ lambda assay for T cells, as long as these two targets, TCR-beta1 and TCR-beta2, can be reliably distinguished. The diagnostic yield of flow cytometric analysis of T-cell populations in liquid samples (blood, bone marrow, cerebrospinal fluid, effusions) has improved with the use of TCR-beta1 and pan-TCR-beta antibodies, and a TCR-beta2 antibody has recently been rationally designed. Until now, no antibodies against the two alternatively used TCR constant regions have been available for formalin fixed paraffin embedded tissue, although we have presented data on in situ hybridisation-based approaches to detecting these targets. Our recent development of a pair of antibodies that work on formalin fixed paraffin embedded tissue will be presented, as this promises to provide the “holy grail” of a kappa/lambda equivalent for T cells.

A case-based presentation addressing approaches to diagnosis of myeloproliferative neoplasms. Classification of myeloproliferative neoplasms is important to guide management and inform prognosis. Challenges arise when either the clinical, morphological or molecular findings do not meet diagnostic criteria or are contradictory. The presentation will discuss situations in which myeloproliferative neoplasms can cause difficulties in classification, and will address cases that mimic clinical or morphological aspects of myeloproliferative neoplasms.