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|colspan="1" style = "width: 4%; font-size:90%; color:navy;" |<u>'''κ/λ'''</u> | |colspan="1" style = "width: 4%; font-size:90%; color:navy;" |<u>'''κ/λ'''</u> | ||
|colspan="1" style = "width: 8%; background:#00b8e6;"| | |colspan="1" style = "width: 8%; background:#00b8e6;"| | ||
|colspan="1" style = "font-size:80%; width: 8%; |wk | |colspan="1" style = "font-size:80%; width: 8%; |wk | ||
|colspan="1" style = "font-size:80%;"|Expect weak or absent restricted κ or λ expression | |colspan="1" style = "font-size:80%;"|Expect weak or absent restricted κ or λ expression | ||
|- | |- | ||
|colspan="1" style = "font-size:90%; color:navy;" |<u>'''FMC7'''</u> | |colspan="1" style = "font-size:90%; color:navy;" |<u>'''FMC7'''</u> | ||
|colspan="1" style = "background:#66e0ff;"| | |colspan="1" style = "background:#66e0ff;"| | ||
|colspan="1" style = "font-size:80%;"| | |colspan="1" style = "font-size:80%;"|- | ||
|colspan="1" style = "font-size:80%;"|May be expressed by atypical cases, generally absent | |colspan="1" style = "font-size:80%;"|May be expressed by atypical cases, generally absent | ||
|- | |- | ||
|colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD5'''</u> | |colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD5'''</u> | ||
|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%;"|Characteristic of CLL, usually less strong than on T cells | |colspan="1" style = "font-size:80%;"|Characteristic of CLL, usually less strong than on T cells | ||
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|colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD19'''</u> | |colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD19'''</u> | ||
|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, but less strong than normal B cells | |colspan="1" style = "font-size:84%;"|Expression is expected, but less strong than normal B cells | ||
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|colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD23'''</u> | |colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD23'''</u> | ||
|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%;"|Characteristic of CLL, although can rarely be weak or absent | |colspan="1" style = "font-size:84%;"|Characteristic of CLL, although can rarely be weak or absent | ||
|- | |- | ||
|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:#00b8e6;"| | ||
|colspan="1" style = "font-size:80%;"|Wk | |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:84%;"|Expressed by many cases of CLL but characteristically weak | ||
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|colspan="1" style = "font-size:90%;" |CD43 | |colspan="1" style = "font-size:90%;" |CD43 | ||
|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%;"|Similar to CD200, may be helpful in some cases | |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%; color:navy;" |<u>'''CD200'''</u> | |colspan="1" style = "font-size:90%; color:navy;" |<u>'''CD200'''</u> | ||
|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%;"|Characteristically positive in CLL and negative in MCL | |colspan="1" style = "font-size:84%;"|Characteristically positive in CLL and negative in MCL | ||
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Revision as of 23:13, 18 June 2023
Background
Typical CLL can be diagnosed with some confidence using flow cytometry.
However, individual markers may not be expressed in all cases - this can cause diagnostic difficulty particularly in distinguishing CLL from atypical cases of MCL or MZL. If this is the case then the atypical features should be reported, and the possibility of alternative diagnoses acknowledged.
Note also that cases with a low lymphocytosis (<1x109) may represent monoclonal B-lymphocytosis with CLL phenotype (click here for more).
Immunophenotype of CLL | |||
---|---|---|---|
Major markers useful in CLL diagnosis | |||
Marker | Freq | Level | Comment |
κ/λ | wk | Expect weak or absent restricted κ or λ expression | |
FMC7 | - | May be expressed by atypical cases, generally absent | |
CD5 | - | Characteristic of CLL, usually less strong than on T cells | |
CD10 | - | Rare in CLL, consider FL if detected | |
CD11C | Wk | Expressed in some cases, but tends to be weak | |
CD19 | - | Expression is expected, but less strong than normal B cells | |
CD20 | Wk | Expression is expected, but characteristically weak | |
CD23 | - | Characteristic of CLL, although can rarely be weak or absent | |
CD25 | Wk | Expressed by many cases of CLL but characteristically weak | |
CD38 | Wk | Expressed by some cases of CLL, typically weak | |
CD43 | - | Similar to CD200, may be helpful in some cases | |
CD79a | Wk | Expression is expected, but characteristically weak | |
CD103 | - | Not expressed by CLL, consider HCL if found | |
CD138 | - | Predominantly expressed at plasma cell differentiation | |
CD200 | - | Characteristically positive in CLL and negative in MCL |
Markers most useful in initial diagnosis are underlined in blue text
Key to table:
Click for key to expression frequency Key
Click for key to expression strength Key
NOTE We offer alternative menus looking at the reactivity of individual markers Here or offering a comparison with related disorders here. These may be helpful in more difficult cases.