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:<span style="color:navy">'''Summary'''</span>
:<span style="color:navy">'''Summary'''</span>


:CD200 is not lineage specific being seen in a lymphoid and myeloid disorders but has an role in diagnosis: CD200 expression aids the distinction between CLL where expression is consistent and mantle cell lymphoma (MCL) where expression is rare. It is important to realise that CD200 is not a CLL-specific marker and is also expressed on a wide range of other neoplastic B cell types
: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)


   
   
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<span style="color:navy">'''Normal expression and function'''</span>
<span style="color:navy">'''Normal expression and function'''</span>


CD200 is a membrane glycoprotein that braodly delivers an inhibitory signal for inflammation in diverse tissues. CD200 is commonly expressed on cells of hematopoietic lineage, specifically macrophages, dendritic cells, neutrophils, mast cells and eosinophils, as well as B cells and activated T cells.  
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.




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<span style="color:navy">'''Diagnostic role'''</span>  
<span style="color:navy">'''Diagnostic role'''</span>  


*CD200 is consisently expressed in chronic lymphocytic leukemia CLL, including cases with atypical morphology or atypical expression of other surface markers
*Most often CD138 used in conjunction with CD38 to identify plasma cells in the diagnosis or monitoring of myeloma
*CD200 not usually expressed by MCL, making CD200 a particularly useful marker for discrimination between CLL and MCL. Note however that expression of MCL has been reported in a small number of cases so the distinction is not absolute
*There is very little aberrant expression, but neoplastic plasma cells may in some cases have weak, variable, or occasionally undetectable expression
*CD200 is overexpressed by many different cell types and is neither lineage nor stage-specific, being expressed by B-cell progenitors and nearly all precursor B lymphoblastic leukemias. It is expressed by over 70% of myelomas, and hairy cell leukemia also exhibits a high level of staining
*Expression is also seen cells that have plasmacytic differentiation in lymphoplasmacytoid lymphoma or marginal zone lymphoma  
*expression in AML is also recorded  




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<span style="color:navy">'''Other useful information'''</span>  
<span style="color:navy">'''Other useful information'''</span>  


CD200 is also expressed on endothelial neuronal cells and cells of the reproductive organs ovaries and placental trophoblasts.  
Outside of haematopoiesis CD138 is expressed by squamous epithelium.


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! 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]]''')
! 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: 14.25%; background: #006699; color:white"|40-80%
|style="width: 12.5%; background: #004466; color:white"|80-100%
|style="width: 12.5%; background: #004466; color:white"|80-100%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 14.25%; background: #00b8e6; color:black"|20-40%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 14.25%; background: #00b8e6; color:black"|20-40%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #004466; color:white"|80-100%
|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%
|-
|-
|}
|}


<span style="font-size:90%">'''Notes:''' The main application is in AML. Aberrant expression is seen in ALL particularly in T-lineage, although it may be less likely in Burkitt lymphoma. CD117 expression can indicate MPAL or ETP-ALL if other markers are consistent.




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! CLL !! MCL !!FL!! MZL !! HCL !! DLBCL || LPL !! PCL
! CLL !! MCL !!FL!! MZL !! HCL !! DLBCL || LPL !! PCL
|-
|-
|style="width: 12.5%; background: #004466; color:white"|80-100%
|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: #66e0ff; color:black"|5-20%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 12.5%; background: #004466; color:white"|80-100%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 14.25%; background: #006699; color:white"|40-80%
|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 common but selective in mature B-lymphoproliferative disorders, with expression being rare in MCL and FL</span>
<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>




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<span style="font-size:90%">'''Notes:''' limited reports are consistent with expression being uncommon in T-lymphoproliferative disorders, but expression has been described in angioimmunoblastic lymphoma</span>
<span style="font-size:90%">'''Notes:''' limited reports are consistent with expression being very uncommon in T-lymphoproliferative disorders</span>
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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