Flow cytometry: Follicular Lymphoma
From haematologyetc.co.uk
Background
Typical MCL expresses CD5, but can be distinguished from CLL by the absence of CD23 and CD200.
However, individual markers may not be expressed in all cases - this can cause diagnostic difficulty particularly with atypical forms of MZL or occasionally other B-cell lymphoproliferative disorders. Generally it is correct to advise cytogenetic or genetic testing to confirm.
Immunophenotype of FL | |||
---|---|---|---|
Major markers useful in CLL diagnosis | |||
Marker | Freq | Level | Comment |
κ/λ | Expect κ or λ expression, undetectable in rare cases | ||
FMC7 | - | Occasionally seen, FMC7 is not typical of FL | |
CD5 | - | Expression of CD5 is characteristic of MCL | |
CD10 | Strg | Expression is expected though not universal in FL | |
CD11C | Expression is not typically seen in FL | ||
CD19 | - | Expression is expected, but may be weak or undectable | |
CD20 | - | Expression is expected, rare cases may have CD20 loss | |
CD23 | - | May be expressed by some cases of FL | |
CD25 | Not typical of FL, where present it is not generally strong | ||
CD38 | - | Expression is expected in FL but CD138 should be absent | |
CD43 | - | Expression is uncommon in FL, may be helpful in some cases | |
CD79a | Expression is expected and should be stronger than CLL | ||
CD103 | - | Not expressed by MCL, consider HCL if found | |
CD138 | - | Predominantly expressed at plasma cell differentiation | |
CD200 | - | Characteristically (though not always) negative in MCL |
Key to table:
Markers most useful in initial diagnosis are underlined in blue text
Key to colour code for expression frequency Click for link
Key to expression strength code and use Click for link