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Use of panels in lymphoproliferative disorders

From www.haematologyetc.co.uk


Click the name of the disorder for detailed information


A: ATLL

The immunophenotype of ATLL is not fully distinctive, but most frequently presents as CD4-expressing T cells with variable and low expression of CD7 and CD3, but bright expression of CD25.


B: B-prolymphocytic leukaemia

B-PLL has no entirely specific marker pattern, and the immunophenotype overlaps with related conditions. However, features of the immunophenotype may suggest or support diagnosis of this condition


C: Chronic lymphocytic leukaemia

The immunophenotype of CLL may be entirely typical allowing confident diagnosis. However, a significant proportion of CLL cases will express atypical markers


F: Follicular lymphoma

FL has precise immunophenotype, but there are significant elements of the immunophenotype that suggest the diagnosis. Confirmation then requires correlation with clinical and pathological features


H: Hairy cell leukaemia and hairy cell variant

HCL has a characteristic immunophenotype phenotype that allows diagnosis with some certainty in typical disease. There is however an overlap with the variant form of HCL and to a lesser extent marginal zone lymphoma.


M:

Marginal zone lymphomas

There is a significant variability in phenotype within the different MZL types and overlap with featureswith other disorders

Monoclonal B-lymphocytosis

A clonal lymphocyte population where the circulating number of clonal B cells and clinical features are is insufficient to diagnose a lymphoproliferative disorder

Myeloma and plasma cell leukaemia

Sometimes a difficult diagnosis by immunophenotype, often requires a combined diagnostic approach


S Sezary cells

Sézary cells typically have the immunophenotype of mature CD4 T cells expressing an α/β TCR. In most cases the phenotype will have additional aberrant features that identify the cells as being abnormal. CD7 or CD26 are the most frequent aberrant antigens, although there is no absolutely specific pattern of abnormality.



SUMMARY TABLES


Table 1: A summary of marker patterns distinguishing CLL, PLL MCL and FL


Table 2: A summary of marker patterns distinguishing HCL, HCL-v and MZL


Table 3: A summary of marker patterns distinguishing Plasma cells and lymphoplasmacytoid cells