Flow cytometry: Marginal Zone Lymphoma: Difference between revisions
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A difficult diagnosis - flow cytometry can suggest a diagnosis, but the immunophenotype may overlap with related diagnoses including atypical cases of CLL and MCL. Generally it is correct to suggest the diagnosis, but recognise that the profile is not fully specific, and confirmation by other modalities may be required. | A difficult diagnosis - flow cytometry can suggest a diagnosis, but the immunophenotype may overlap with related diagnoses including atypical cases of CLL and MCL. Generally it is correct to suggest the diagnosis, but recognise that the profile is not fully specific, and confirmation by other modalities may be required. | ||
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!colspan="4" style = "font-size:110%; color: navy; text-align:center; background:#DEE0DE;"|'''Immunophenotype of MZL''' | !colspan="4" style = "font-size:110%; color: navy; text-align:center; background:#DEE0DE;"|'''Immunophenotype of MZL''' | ||
|- | |- | ||
!colspan="4" style = "font-size:90%; background:#DAE8F2"|'''Major markers useful in | !colspan="4" style = "font-size:90%; background:#DAE8F2"|'''CD45''' expression | ||
|- | |||
|colspan="4" style = "font-size:90%; color:black;" |Typically expression of CD45 approaches that of normal T and B cells. | |||
|- | |||
!colspan="4" style = "font-size:90%; background:#DAE8F2"|Major markers useful in diagnosis | |||
|- | |- | ||
|colspan="1" style = "font-size:80%; width: 4%; |'''Marker''' | |colspan="1" style = "font-size:80%; width: 4%; |'''Marker''' | ||
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|colspan="1" style = "font-size:80%; width: 80%; |'''Comment''' | |colspan="1" style = "font-size:80%; width: 80%; |'''Comment''' | ||
|- | |- | ||
|colspan="1" style = "width: 4%; font-size:90%; color: | |colspan="1" style = "width: 4%; font-size:90%; color:black;" |κ/λ | ||
|colspan="1" style = "width: 8%; background:#004466;"| | |colspan="1" style = "width: 8%; background:#004466;"| | ||
|colspan="1" style = "font-size:80%; width: 8%; | | |colspan="1" style = "font-size:80%; width: 8%; | | ||
|colspan="1" style = "font-size:80%;"|Expect moderate or strong restricted κ or λ expression | |colspan="1" style = "font-size:80%;"|Expect moderate or strong restricted κ or λ expression | ||
|- | |- | ||
|colspan="1" style = "font-size:90%; color: | |colspan="1" style = "font-size:90%; color:black;" |FMC7 | ||
|colspan="1" style = "background:#006699;"| | |colspan="1" style = "background:#006699;"| | ||
|colspan="1" style = "font-size:80%;"|- | |colspan="1" style = "font-size:80%;"|- | ||
|colspan="1" style = "font-size:80%;"|FMC7 may be expressed in MZL and may be strong | |colspan="1" style = "font-size:80%;"|FMC7 may be expressed in MZL and may be strong | ||
|- | |- | ||
|colspan="1" style = "font-size:90%; color: | |colspan="1" style = "font-size:90%; color:black;" |CD5 | ||
|colspan="1" style = "background:# | |colspan="1" style = "background:#66e0ff;"| | ||
|colspan="1" style = "font-size:80%;"|- | |colspan="1" style = "font-size:80%;"|- | ||
|colspan="1" style = "font-size:80%;"|Expression of CD5 is uncommon in MZL | |colspan="1" style = "font-size:80%;"|Expression of CD5 is uncommon in MZL | ||
|- | |- | ||
|colspan="1" style = "font-size:90%;" |CD10 | |colspan="1" style = "font-size:90%;" |CD10 | ||
|colspan="1" style = "background:# | |colspan="1" style = "background:#66e0ff;"| | ||
|colspan="1" style = "font-size:80%;"|- | |colspan="1" style = "font-size:80%;"|- | ||
|colspan="1" style = "font-size:84%;"|Infrequently expressed, expression may suggest FL | |colspan="1" style = "font-size:84%;"|Infrequently expressed, expression may suggest FL | ||
|- | |- | ||
|colspan="1" style = "font-size:90%;" |CD11C | |colspan="1" style = "font-size:90%;" |CD11C | ||
|colspan="1" style = "background:# | |colspan="1" style = "background:#006699;"| | ||
|colspan="1" style = "font-size:80%;"| | |colspan="1" style = "font-size:80%;"| | ||
|colspan="1" style = "font-size:84%;"| | |colspan="1" style = "font-size:84%;"|Frequently expressed in MZL and should be looked for | ||
|- | |- | ||
|colspan="1" style = "font-size:90%; color: | |colspan="1" style = "font-size:90%; color:black;" |CD19 | ||
|colspan="1" style = "background:#004466;"| | |colspan="1" style = "background:#004466;"| | ||
|colspan="1" style = "font-size:80%;"|- | |colspan="1" style = "font-size:80%;"|- | ||
|colspan="1" style = "font-size:84%;"|Expression is expected, typically more strongly than in CLL | |colspan="1" style = "font-size:84%;"|Expression is expected, typically more strongly than in CLL | ||
|- | |||
!colspan="4" style = "font-size:90%; background:#DAE8F2"|Other relevant markers | |||
|- | |- | ||
|colspan="1" style = "font-size:90%;" |CD20 | |colspan="1" style = "font-size:90%;" |CD20 | ||
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|colspan="1" style = "font-size:84%;"|Expression is expected, typically stronger than CLL | |colspan="1" style = "font-size:84%;"|Expression is expected, typically stronger than CLL | ||
|- | |- | ||
|colspan="1" style = "font-size:90%; color: | |colspan="1" style = "font-size:90%; color:black;" |CD23 | ||
|colspan="1" style = "background:# | |colspan="1" style = "background:#66e0ff;"| | ||
|colspan="1" style = "font-size:80%;"|- | |colspan="1" style = "font-size:80%;"|- | ||
|colspan="1" style = "font-size:84%;"|Typically not expressed by | |colspan="1" style = "font-size:84%;"|Typically not expressed by MZL, may rarely be expressed | ||
|- | |- | ||
|colspan="1" style = "font-size:90%; color:black;" |CD25 | |colspan="1" style = "font-size:90%; color:black;" |CD25 | ||
|colspan="1" style = "background:#00b8e6;"| | |colspan="1" style = "background:#00b8e6;"| | ||
|colspan="1" style = "font-size:80%;"| | |colspan="1" style = "font-size:80%;"| | ||
|colspan="1" style = "font-size:84%;"| | |colspan="1" style = "font-size:84%;"|May be expressed by MZL, not generally strong as HCL | ||
|- | |- | ||
|colspan="1" style = "font-size:90%; color:black;" |CD38 | |colspan="1" style = "font-size:90%; color:black;" |CD38 | ||
|colspan="1" style = "background:#004466;"| | |colspan="1" style = "background:#004466;"| | ||
|colspan="1" style = "font-size:80%;"|- | |colspan="1" style = "font-size:80%;"|- | ||
|colspan="1" style = "font-size:84%;"|Expression is expected in | |colspan="1" style = "font-size:84%;"|Expression is expected in MZL but CD138 should be absent | ||
|- | |- | ||
|colspan="1" style = "font-size:90%;" |CD43 | |colspan="1" style = "font-size:90%;" |CD43 | ||
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|colspan="1" style = "font-size:84%;"|Lower expression than in CLL, may be helpful in some cases | |colspan="1" style = "font-size:84%;"|Lower expression than in CLL, may be helpful in some cases | ||
|- | |- | ||
|colspan="1" style = "font-size:90%; color: | |colspan="1" style = "font-size:90%; color:black;" |CD79b | ||
|colspan="1" style = "background:#004466;"| | |colspan="1" style = "background:#004466;"| | ||
|colspan="1" style = "font-size:80%;"| | |colspan="1" style = "font-size:80%;"| | ||
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|colspan="1" style = "background:#E6FAFF;"| | |colspan="1" style = "background:#E6FAFF;"| | ||
|colspan="1" style = "font-size:80%;"|- | |colspan="1" style = "font-size:80%;"|- | ||
|colspan="1" style = "font-size:84%;"|Not | |colspan="1" style = "font-size:84%;"|Not expected in MZL, consider HCL if found | ||
|- | |- | ||
|colspan="1" style = "font-size:90%;" |CD138 | |colspan="1" style = "font-size:90%;" |CD138 | ||
|colspan="1" style = "background:# | |colspan="1" style = "background:#66e0ff;"| | ||
|colspan="1" style = "font-size:80%;"|- | |colspan="1" style = "font-size:80%;"|- | ||
|colspan="1" style = "font-size:84%;"| | |colspan="1" style = "font-size:84%;"|Expression may occur in MZL | ||
|- | |- | ||
|colspan="1" style = "font-size:90%; color: | |colspan="1" style = "font-size:90%; color:black;" |CD200 | ||
|colspan="1" style = "background:# | |colspan="1" style = "background:#66e0ff;"| | ||
|colspan="1" style = "font-size:80%;"|- | |colspan="1" style = "font-size:80%;"|- | ||
|colspan="1" style = "font-size:84%;"| | |colspan="1" style = "font-size:84%;"|Expression is obseved in MZL | ||
|- | |- | ||
|} | |} | ||
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<span style="color:navy;font-size:80% ">'''Key to table: '''</span> | <span style="color:navy;font-size:80% ">'''Key to table: '''</span> | ||
<span style="font-size:80% ">Key to colour code for expression frequency [[Key_to_marker_expression_table|Click for link]]</span> | <span style="font-size:80% ">Key to colour code for expression frequency [[Key_to_marker_expression_table|Click for link]]</span> |
Latest revision as of 17:18, 13 July 2023
Background to flow cytometric diagnosis
A difficult diagnosis - flow cytometry can suggest a diagnosis, but the immunophenotype may overlap with related diagnoses including atypical cases of CLL and MCL. Generally it is correct to suggest the diagnosis, but recognise that the profile is not fully specific, and confirmation by other modalities may be required.
Immunophenotype of MZL | |||
---|---|---|---|
CD45 expression | |||
Typically expression of CD45 approaches that of normal T and B cells. | |||
Major markers useful in diagnosis | |||
Marker | Freq | Level | Comment |
κ/λ | Expect moderate or strong restricted κ or λ expression | ||
FMC7 | - | FMC7 may be expressed in MZL and may be strong | |
CD5 | - | Expression of CD5 is uncommon in MZL | |
CD10 | - | Infrequently expressed, expression may suggest FL | |
CD11C | Frequently expressed in MZL and should be looked for | ||
CD19 | - | Expression is expected, typically more strongly than in CLL | |
Other relevant markers | |||
CD20 | - | Expression is expected, typically stronger than CLL | |
CD23 | - | Typically not expressed by MZL, may rarely be expressed | |
CD25 | May be expressed by MZL, not generally strong as HCL | ||
CD38 | - | Expression is expected in MZL but CD138 should be absent | |
CD43 | - | Lower expression than in CLL, may be helpful in some cases | |
CD79b | Expression is expected and should be stronger than CLL | ||
CD103 | - | Not expected in MZL, consider HCL if found | |
CD138 | - | Expression may occur in MZL | |
CD200 | - | Expression is obseved in MZL |
Key to table:
Key to colour code for expression frequency Click for link
Key to expression strength code and use Click for link