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Flow cytometry: Follicular Lymphoma: Difference between revisions

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file:FL.jpg|link={{filepath:FL.jpg}}
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<span style="color: navy>'''Background'''</span>
<span style="color: navy>'''Background'''</span>


Typical MCL expresses CD5, but can be distinguished from CLL by the absence of CD23 and CD200.  
Follicular lymphoma expresses CD10, with other immunophenotypic featues differing from related disorders.  


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.
However, individual markers may not be expressed in all cases - confirmation can be made from histopathology, cytogenetic or genetic testing.




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!colspan="4" style = "font-size:110%; color: navy; text-align:center; background:#DEE0DE;"|'''Immunophenotype of FL'''
!colspan="4" style = "font-size:110%; color: navy; text-align:center; background:#DEE0DE;"|'''Immunophenotype of FL'''
|-
|-
!colspan="4" style = "font-size:90%; background:#DAE8F2"|'''Major markers useful in CLL diagnosis'''  
!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:navy;" |<u>'''κ/λ'''</u>
|colspan="1" style = "width: 4%; font-size:90%; color:black;" |κ/λ
|colspan="1" style = "width: 8%; background:#006699;"|
|colspan="1" style = "width: 8%; background:#006699;"|
|colspan="1" style = "font-size:80%; width: 8%; |
|colspan="1" style = "font-size:80%; width: 8%; |
|colspan="1" style = "font-size:80%;"|Expect κ or λ expression, undetectable in rare cases
|colspan="1" style = "font-size:80%;"|Expect κ or λ expression, undetectable in rare cases
|-
|-
|colspan="1" style = "font-size:90%; color:navy;" |<u>'''FMC7'''</u>
|colspan="1" style = "font-size:90%; color:black;" |CD19
|colspan="1" style = "background:#00b8e6;"|
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|Occasionally seen, FMC7 is not typical of FL
|colspan="1" style = "font-size:84%;"|Expression is expected, but may be weak or undectable
|-
|-
|colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD5'''</u>
|colspan="1" style = "font-size:90%; color:black;" |CD5
|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:80%;"|Expression of CD5 is characteristic of MCL
|colspan="1" style = "font-size:80%;"|Expression of CD5 is characteristic of MCL
|-
|-
|colspan="1" style = "font-size:90%;" |CD10
|colspan="1" style = "font-size:90%; color:black;" |CD10
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|Strg
|colspan="1" style = "font-size:80%;"|Strg
|colspan="1" style = "font-size:84%;"|Expression is expected though not universal in FL
|colspan="1" style = "font-size:84%;"|Expression is expected though not universal in FL
|-
|-
|colspan="1" style = "font-size:90%;" |CD11C
|colspan="1" style = "font-size:90%; color:black;" |CD23
|colspan="1" style = "background:#00b8e6;"|
|colspan="1" style = "background:#00b8e6;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|May be expressed by some cases of FL
|-
|colspan="1" style = "font-size:90%; color:black;" |CD79b
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|
|colspan="1" style = "font-size:80%;"|
|colspan="1" style = "font-size:84%;"|Expressed in some cases of MCL but not typical
|colspan="1" style = "font-size:84%;"|Expression is expected and should be stronger than CLL
|-
|-
|colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD19'''</u>
|colspan="1" style = "font-size:90%; color:black;" |CD200
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "background:#E6FAFF;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Characteristically (though not always) negative in FL
|-
|colspan="1" style = "font-size:90%; color:black;" |FMC7
|colspan="1" style = "background:#00b8e6;"|
|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:80%;"|Occasionally seen, FMC7 is not typical of FL
|-
!colspan="4" style = "font-size:90%; background:#DAE8F2"|Other relevant markers
|-
|colspan="1" style = "font-size:90%;" |CD11C
|colspan="1" style = "background:#E6FAFF;"|
|colspan="1" style = "font-size:80%;"|
|colspan="1" style = "font-size:84%;"|Expression is not typically seen in FL
|-
|-
|colspan="1" style = "font-size:90%;" |CD20
|colspan="1" style = "font-size:90%;" |CD20
|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 stronger than CLL
|colspan="1" style = "font-size:84%;"|Expression is expected, rare cases may have CD20 loss
|-
|colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD23'''</u>
|colspan="1" style = "background:#00b8e6;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Typically not expressed by MCL, 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:#E6FAFF;"|
|colspan="1" style = "font-size:80%;"|
|colspan="1" style = "font-size:80%;"|
|colspan="1" style = "font-size:84%;"|Not typical of MCL, not generally strong as HCL
|colspan="1" style = "font-size:84%;"|Not typical of FL, where present it is not generally strong
|-
|-
|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 MCL but CD138 should be absent
|colspan="1" style = "font-size:84%;"|Expression is expected in FL but CD138 should be absent
|-
|-
|colspan="1" style = "font-size:90%;" |CD43
|colspan="1" style = "font-size:90%;" |CD43
|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%;"|Lower expression than in CLL, may be helpful in some cases
|colspan="1" style = "font-size:84%;"|Expression is uncommon in FL, may be helpful in some cases
|-
|colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD79a'''</u>
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|
|colspan="1" style = "font-size:84%;"|Expression is expected and should be stronger than CLL
|-
|-
|colspan="1" style = "font-size:90%;" |CD103
|colspan="1" style = "font-size:90%;" |CD103
|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 expressed by MCL, consider HCL if found
|colspan="1" style = "font-size:84%;"|Not expressed by FL, consider HCL if found
|-
|-
|colspan="1" style = "font-size:90%;" |CD138
|colspan="1" style = "font-size:90%;" |CD138
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|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Predominantly expressed at plasma cell differentiation  
|colspan="1" style = "font-size:84%;"|Predominantly expressed at plasma cell differentiation  
|-
|colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD200'''</u>
|colspan="1" style = "background:#E6FAFF;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Characteristically (though not always) negative in MCL
|-
|-
|}
|}
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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% ">Markers most useful in initial diagnosis are <span style=color:navy><u>underlined in blue text</u></span></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 17:17, 13 July 2023

  • FL.jpg


Background

Follicular lymphoma expresses CD10, with other immunophenotypic featues differing from related disorders.

However, individual markers may not be expressed in all cases - confirmation can be made from histopathology, cytogenetic or genetic testing.


Immunophenotype of FL
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 κ or λ expression, undetectable in rare cases
CD19 - Expression is expected, but may be weak or undectable
CD5 - Expression of CD5 is characteristic of MCL
CD10 Strg Expression is expected though not universal in FL
CD23 - May be expressed by some cases of FL
CD79b Expression is expected and should be stronger than CLL
CD200 - Characteristically (though not always) negative in FL
FMC7 - Occasionally seen, FMC7 is not typical of FL
Other relevant markers
CD11C Expression is not typically seen in FL
CD20 - Expression is expected, rare cases may have CD20 loss
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
CD103 - Not expressed by FL, consider HCL if found
CD138 - Predominantly expressed at plasma cell differentiation


Key to table:

Key to colour code for expression frequency Click for link

Key to expression strength code and use Click for link


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