View source for Flow cytometry: Chronic Lymphocytic leukaemia

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<span style="color: navy>'''Background to flow cytometric diagnosis'''</span>

Typical CLL can be diagnosed with some confidence using flow cytometry. However, individual markers may not be expressed in all cases - particularly it may be difficult to distinguish atypical CLL from some cases of MCL or MZL. 
*Atypical features should always be reported and the possibility of alternative diagnoses acknowledged.
*Cases with a low lymphocytosis (<1x10<sup>9</sup>) may represent monoclonal B-lymphocytosis with CLL phenotype [[Monoclonal B lymphocytosis|(click here for diagnostic criteria)]]. 



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{| class="wikitable" style="color:black; background-color:#ffffff;" cellpadding="5"
!colspan="4" style = "font-size:110%; color: navy; text-align:center; background:#DEE0DE;"|'''Immunophenotype of CLL'''
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!colspan="4" style = "font-size:90%; background:#DAE8F2"|'''CD45''' expression
|-
|colspan="4" style = "font-size:90%; color:black;" |Typically expression of CD45 is less intense than normal T or B cells, with many cases showing variable expression with a wide spread of CD45 intensity.
|-
!colspan="4" style = "font-size:90%; background:#DAE8F2"|Major markers useful in CLL diagnosis 
|-
|colspan="1" style = "font-size:80%; width: 4%; |'''Marker'''
|colspan="1" style = "font-size:80%; width: 8%; |'''Freq'''
|colspan="1" style = "font-size:80%; width: 8%; |'''Level'''
|colspan="1" style = "font-size:80%; width: 80%; |'''Comment'''
|-
|colspan="1" style = "font-size:90%; color:black;" |'''CD19'''
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Expression is expected, but less strong than normal B cells
|-
|colspan="1" style = "width: 4%; font-size:90%; color:black;" |'''κ/λ'''
|colspan="1" style = "width: 8%; background:#00b8e6;"|
|colspan="1" style = "font-size:80%; width: 8%; |
|colspan="1" style = "font-size:80%;"|Expect weak restricted κ or λ or absent expression
|-
|colspan="1" style = "font-size:90%; color:black;" |'''CD5'''
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|Characteristic of CLL, usually less strong than on T cells
|-
|colspan="1" style = "font-size:90%; color:black;" |'''CD23'''
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Characteristic of CLL, although can rarely be weak or absent
|-
|colspan="1" style = "font-size:90%; color:black;" |'''CD79b'''
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|wk
|colspan="1" style = "font-size:84%;"|Expression is expected, but characteristically weak
|-
|colspan="1" style = "font-size:90%; color:black;" |'''CD200'''
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Characteristically positive in CLL and negative in MCL
|-
|colspan="1" style = "font-size:90%; color:black;" |'''FMC7'''
|colspan="1" style = "background:#66e0ff;"|
|colspan="1" style = "font-size:80%;"|
|colspan="1" style = "font-size:80%;"|May be expressed by atypical cases, generally absent
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!colspan="4" style = "font-size:90%; background:#DAE8F2"|Other relevant markers 
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|colspan="1" style = "font-size:90%;" |CD10
|colspan="1" style = "background:#00b8e6;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Infrequent in CLL, consider FL if detected
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|colspan="1" style = "font-size:90%;" |CD11C
|colspan="1" style = "background:#00b8e6;"|
|colspan="1" style = "font-size:80%;"|wk
|colspan="1" style = "font-size:84%;"|Expressed in some cases, but tends to be weak
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|colspan="1" style = "font-size:90%;" |CD20
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|wk
|colspan="1" style = "font-size:84%;"|Expression is expected, but characteristically weak
|-
|colspan="1" style = "font-size:90%; color:black;" |CD25
|colspan="1" style = "background:#00b8e6;"|
|colspan="1" style = "font-size:80%;"|wk
|colspan="1" style = "font-size:84%;"|Expressed by many cases of CLL but characteristically weak
|-
|colspan="1" style = "font-size:90%; color:black;" |CD38
|colspan="1" style = "background:#66e0ff;"|
|colspan="1" style = "font-size:80%;"|wk
|colspan="1" style = "font-size:84%;"|Expressed by some cases of CLL, typically weak
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|colspan="1" style = "font-size:90%;" |CD43
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Similar to CD200, may be helpful in some cases
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|colspan="1" style = "font-size:90%;" |CD103
|colspan="1" style = "background:#E6FAFF;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Not expressed by CLL, consider HCL if found
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|colspan="1" style = "font-size:90%;" |CD138
|colspan="1" style = "background:#E6FAFF;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Predominantly expressed at plasma cell differentiation 
|-
|}
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<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 expression strength code and use [[Expression strength key|Click for link]]</span>



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