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Flow cytometry: Marginal Zone Lymphoma

From haematologyetc.co.uk




Background to flow cytometric diagnosis

A difficult diagnosis - flow cytometry can suggest a diagnosis, but the immunophenotype may overlap with related diagnoses including atypical cases of CLL and MCL. Generally it is correct to suggest the diagnosis, but recognise that the profile is not fully specific, and confirmation by other modalities may be required.


Immunophenotype of MZL
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 moderate or strong restricted κ or λ expression
FMC7 - FMC7 may be expressed in MZL and may be strong
CD5 - Expression of CD5 is uncommon in MZL
CD10 - Infrequently expressed, expression may suggest FL
CD11C Frequently expressed in MZL and should be looked for
CD19 - Expression is expected, typically more strongly than in CLL
Other relevant markers
CD20 - Expression is expected, typically stronger than CLL
CD23 - Typically not expressed by MZL, may rarely be expressed
CD25 May be expressed by MZL, not generally strong as HCL
CD38 - Expression is expected in MZL but CD138 should be absent
CD43 - Lower expression than in CLL, may be helpful in some cases
CD79b Expression is expected and should be stronger than CLL
CD103 - Not expected in MZL, consider HCL if found
CD138 - Expression may occur in MZL
CD200 - Expression is obseved in MZL


Key to table:

Key to colour code for expression frequency Click for link

Key to expression strength code and use Click for link