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Flow cytometry: Mantle cell Lymphoma: Difference between revisions

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[[file:MCL.jpg|200px|link=MCL.jpg]]   
[[file:MCL.jpg|200px|link=MCL.jpg]]   
<span style="font-size:90%">''Typical MCL morphology''</span>




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Typical MCL expresses CD5, but can be distinguished from CLL by the absence of CD23 and CD200.  
Typical MCL expresses CD5, but can be distinguished from CLL by the absence of CD23 and CD200.  


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 - this can cause diagnostic difficulty particularly with atypical forms of CLL or MZL or occasionally other B-cell lymphoproliferative disorders. Generally it is correct to advise cytogenetic or genetic testing to confirm.




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!colspan="4" style = "font-size:110%; color: navy; text-align:center; background:#DEE0DE;"|'''Immunophenotype of MCL'''
!colspan="4" style = "font-size:110%; color: navy; text-align:center; background:#DEE0DE;"|'''Immunophenotype of MCL'''
|-
|-
!colspan="4" style = "font-size:90%; background:#DAE8F2"|'''Major markers useful in CLL diagnosis'''
!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:#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:navy;" |<u>'''FMC7'''</u>
|colspan="1" style = "font-size:90%; color:black;" |CD19
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|FMC7 is frequently expressed by typical MCL
|colspan="1" style = "font-size:84%;"|Expression is expected, typically more strongly than in CLL
|-
|-
|colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD5'''</u>
|colspan="1" style = "font-size:90%; color:black;" |CD5
|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: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%; color:black;" |CD23
|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;" |CD79b
|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%; color:black;" |CD200
|colspan="1" style = "background:#E6FAFF;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Characteristically (though not always) negative in MCL
|-
|colspan="1" style = "font-size:90%; color:black;" |FMC7
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|FMC7 is frequently expressed by typical MCL
|-
!colspan="4" style = "font-size:90%; background:#DAE8F2"|Other relevant markers
|-
|-
|colspan="1" style = "font-size:90%;" |CD10
|colspan="1" style = "font-size:90%;" |CD10
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|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%;"|Expressed in some cases of MCL but not typical
|-
|colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD19'''</u>
|colspan="1" style = "background:#004466;"|
|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:90%;" |CD20
|colspan="1" style = "font-size:90%;" |CD20
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|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, typically stronger than CLL
|-
|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
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|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%;"|Lower expression than in CLL, may be helpful in some cases
|-
|colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD79b'''</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
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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 16:18, 11 July 2023

MCL.jpg


Background

Typical MCL expresses CD5, but can be distinguished from CLL by the absence of CD23 and CD200.

However, individual markers may not be expressed in all cases - this can cause diagnostic difficulty particularly with atypical forms of CLL or MZL or occasionally other B-cell lymphoproliferative disorders. Generally it is correct to advise cytogenetic or genetic testing to confirm.


Immunophenotype of MCL
Major markers useful in diagnosis
Marker Freq Level Comment
κ/λ Expect moderate or strong restricted κ or λ expression
CD19 - Expression is expected, typically more strongly than in CLL
CD5 - Expression of CD5 is characteristic of MCL
CD23 - Typically not expressed by MCL, may rarely be expressed
CD79b Expression is expected and should be stronger than CLL
CD200 - Characteristically (though not always) negative in MCL
FMC7 - FMC7 is frequently expressed by typical MCL
Other relevant markers
CD10 - Infrequently expressed, expression may suggest FL
CD11C Expressed in some cases of MCL but not typical
CD20 - Expression is expected, typically stronger than CLL
CD25 Not typical of MCL, not generally strong as HCL
CD38 - Expression is expected in MCL but CD138 should be absent
CD43 - Lower expression than in CLL, may be helpful in some cases
CD103 - Not expressed by MCL, 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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