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tdt


tdt terminal deoxynucleotidyl transferase is expressed in the cell nucleus; detection therefore requires permeabilised cells. expression is expected in acute lymphoblastic leukaemias but is commonly also found in acute myeloid leukaemia. tdt is also strongly expressed by early haematogones and can help distinguish them from mature b cells; expression is lost as haematogones mature 
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what is its normal function and expression  tdt acts during the v d j rearrangement of heavy chain of the t-cell receptor or b-cell receptor gene segments required for the formation of mature b and t cells in thymus or marrow. expression of tdt in normal cells is restricted to immature b-cells in bone marrow. in the t-lymphocyte lineage it is expressed by pre-t lymphoid cells and cortical thymocytes. in regenerative marrows tdt is consistently expressed on regenerative b lymphocytes haematogones which may represent a large proportion of cells in some cases particularly in children . 


what is its diagnostic role  the most useful attribute of tdt is its loss of expression by mature cells. *tdt is expressed by haematogones becoming lost as they mature *tdt is consistently expressed by acute lymphoblastic leukaemia 95 *tdt may be weakly expressed by burkitt lymphoma but is most often absent mature b-cell lymphomas should not express tdt although it is rarely described *tdt is expressed infrequently in aml mainly on less differentiated forms and those related to mds around 20
:<span style="color:navy">'''Summary'''</span>


summary tables 
:CD138 is a marker used to identify normal or malignant plasma cells with a high level of specificity, but does not discriminate normal from abnormal plasma cells and in some cases expression in myeloma may be low compared with normal plasma cells so sensitivity can be an issue. Abberancy of expression is low, but expression may be seen in lymphoplamacytic or marginal zone lymphomas (only on those cells that have plasma cell differentiation)


expression by acute leukaemias and by haematogones  
   
hi  pro-b all   
</div>
hi  early pre-b all   
hi  pre-b all   
poss  b all   
hi  pro-t all   
hi  mature-t all   
mod  aml 
hi  haemato-gones   
*  may be secondary or more primitive forms


expression by b-lymphoproliferative disorders  
 
rare cll 
 
rare  pll 
<span style="color:navy">'''Normal expression and function'''</span>
rare  mcl 
 
rare  fl 
CD138 is a membrane protein that supports cell adhesion or binds cytokines and chemokines. In the hematopoietic system expression of CD138 is acquired by B lymphocytes as they develop into plasma cells.
rare  hcl 
 
rare  hclv 
 
rare  mzl 
 
rare  lpl 
 
rare  pcs
<span style="color:navy">'''Diagnostic role'''</span>
 
*Most often CD138 used in conjunction with CD38 to identify plasma cells in the diagnosis or monitoring of myeloma
*There is very little aberrant expression, but neoplastic plasma cells may in some cases have weak, variable, or occasionally undetectable expression  
*Expression is also seen cells that have plasmacytic differentiation in lymphoplasmacytoid lymphoma or marginal zone lymphoma 
 
 
 
<span style="color:navy">'''Other useful information'''</span>
 
Outside of haematopoiesis CD138 is expressed by squamous epithelium.
 
----
 
<span style="color:navy">'''''SUMMARY TABLES'''''</span>
 
 
{| class=wikitable style="text-align: center; font-size:80%; width: 87.5%; height 20px;"
|-
!colspan="7"|<span style="font-size:100%">'''Expression: primitive cell types''' ''Click (i) on table for additional information'' </span></font>
|-
! AML !! B ALL !! Burkitt || T ALL !! ETP ALL ('''[[Early T Precursor ALL (ETP-ALL)|i]]''') !! MPAL ('''[[Mixed Phenotype Acute Leukaemia (MPAL)|i]]) || H.gones ('''[[Haematogones|i]]''')
|-
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|-
|}
 
 
 
{| class=wikitable style="text-align: center; font-size:80%; width: 100%; height 20px;"
|-
!colspan="8"|'''Expression: mature B cell neoplasms'''
|-
! CLL !! MCL !!FL!! MZL !! HCL !! DLBCL || LPL !! PCL
|-
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 14.25%; background: #006699; color:white"|40-80%
|style="width: 12.5%; background: #004466; color:white"|80-100%
|-
|}
 
<span style="font-size:90%">'''Notes:''' expression is usual in myeloma, and will occur on cells with plasma cell differentiation in LPL or MZL</span>
 
 
 
{| class=wikitable style="text-align: center; font-size:80%; width: 62.4%; height 40px;"
|-
!colspan="7"|'''Expression: mature T cell neoplasms'''
|-
! ATLL !! CTCL Sezary !! T-PLL !! T-LGL !! NK-LGL
|-
|style= "width: 20%; background: #FFE4E1; color:black"|limited
|style="width: 20%; background: #FFE4E1; color:black"|limited
|style="width: 20%; background: #FFE4E1; color:black"|limited
|style= "width: 20%; background: #FFE4E1; color:black"|limited
|style="width: 20%; background: #FFE4E1; color:black"|limited
|-
|}
 
<span style="font-size:90%">'''Notes:''' limited reports are consistent with expression being very uncommon in T-lymphoproliferative disorders</span>
----

Latest revision as of 20:53, 13 June 2023


Summary
CD138 is a marker used to identify normal or malignant plasma cells with a high level of specificity, but does not discriminate normal from abnormal plasma cells and in some cases expression in myeloma may be low compared with normal plasma cells so sensitivity can be an issue. Abberancy of expression is low, but expression may be seen in lymphoplamacytic or marginal zone lymphomas (only on those cells that have plasma cell differentiation)



Normal expression and function

CD138 is a membrane protein that supports cell adhesion or binds cytokines and chemokines. In the hematopoietic system expression of CD138 is acquired by B lymphocytes as they develop into plasma cells.



Diagnostic role

  • Most often CD138 used in conjunction with CD38 to identify plasma cells in the diagnosis or monitoring of myeloma
  • There is very little aberrant expression, but neoplastic plasma cells may in some cases have weak, variable, or occasionally undetectable expression
  • Expression is also seen cells that have plasmacytic differentiation in lymphoplasmacytoid lymphoma or marginal zone lymphoma


Other useful information

Outside of haematopoiesis CD138 is expressed by squamous epithelium.


SUMMARY TABLES


Expression: primitive cell types Click (i) on table for additional information
AML B ALL Burkitt T ALL ETP ALL (i) MPAL (i) H.gones (i)
<5% <5% <5% <5% <5% <5% <5%


Expression: mature B cell neoplasms
CLL MCL FL MZL HCL DLBCL LPL PCL
<5% <5% <5% 5-20% <5% 5-20% 40-80% 80-100%

Notes: expression is usual in myeloma, and will occur on cells with plasma cell differentiation in LPL or MZL


Expression: mature T cell neoplasms
ATLL CTCL Sezary T-PLL T-LGL NK-LGL
limited limited limited limited limited

Notes: limited reports are consistent with expression being very uncommon in T-lymphoproliferative disorders