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file:PC.jpg|link={{filepath:PC.jpg}}
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[[file:LPL.jpg|200px|link=LPL.jpg]] 




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


Cells of LPL share features of mature B-cell differentation and features of early plasma cell differentiation, and have mixed populations with features of each (although proportions vary). This can be a challenging diagnosis by flow cytometry alone, but other modalities can generally make this diagnosis clear.
Differentiation to plasma cells involves (in mast cases) the loss of typical pan B-cell markers and surface light chains. The expression of CD45 also differs both within and between cases making standard gating strategies difficult to apply. Cells are most often identified through their co-expression of CD138 with a relatively high expression of CD38, together with the absence of typical B-cell features.




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<div style="width: 95%; overflow: auto; border: 1px solid navy; font-size:100%">
<div style="width: 95%; overflow: auto; border: 1px solid navy; font-size:100%">
{| class="wikitable" style="color:black; background-color:#ffffff;" cellpadding="5"
{| 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 LPL'''
!colspan="4" style = "font-size:110%; color: navy; text-align:center; background:#DEE0DE;"|'''Immunophenotype of plasma cells'''
|-
|-
!colspan="4" style = "font-size:90%; background:#DAE8F2"|'''CD45''' expression
!colspan="4" style = "font-size:90%; background:#DAE8F2"|'''CD45''' expression
|-
|-
|colspan="4" style = "font-size:90%; color:black;" |Typically expression of CD45 is similar to that of normal T and B cells.
|colspan="4" style = "font-size:90%; color:black;" |There is no consistent pattern of expression of CD45 although it is most often weak, but may be variable and is occasionally strong.
|-
|-
!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 plasma cell identification
|-
|-
|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 = "font-size:90%; color:black;" |CD19
|colspan="1" style = "font-size:90%; color:black;" |CD38
|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:84%;"|Generally CD19 will be expressed
|colspan="1" style = "font-size:84%;"|The relatively strong expression of CD38 is typical of plasma cells
|-
|-
|colspan="1" style = "font-size:90%; color:black;" |CD38
|colspan="1" style = "font-size:90%;" |CD138
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|var
|colspan="1" style = "font-size:84%;"|
|colspan="1" style = "font-size:84%;"|Expression is expected although the intensity can vary
|-
|-
|colspan="1" style = "width: 4%; font-size:90%; color:black;" |κ/λ
|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:#E6FAFF;"|
|colspan="1" style = "font-size:80%; width: 8%; |
|colspan="1" style = "font-size:80%; width: 8%; |
|colspan="1" style = "font-size:80%;"|Light chain retriction usually detected
|colspan="1" style = "font-size:80%;"|Surface light chain expression is lost (internal will be detected in permeabilised cells)
|-
|-
|colspan="1" style = "font-size:90%; color:black;" |CD5
|colspan="1" style = "font-size:90%; color:black;" |CD19
|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%;"|Uncommon but seen in some cases
|colspan="1" style = "font-size:84%;"|Expression of CD19 may persist in some cases  
|-
|-
|colspan="1" style = "font-size:90%;" |CD138
!colspan="4" style = "font-size:90%; background:#DAE8F2"|Other relevant markers
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "font-size:80%;"|var
|colspan="1" style = "font-size:84%;"|Particularly on cells with plasma cell features
|-
|-
|colspan="1" style = "font-size:90%; color:black;" |CD200
|colspan="1" style = "font-size:90%; color:black;" |CD5
|colspan="1" style = "background:#66e0ff;"|
|colspan="1" style = "background:#E6FAFF;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Detected infrequently
|colspan="1" style = "font-size:80%;"|Not detected on plasma cells
|-
|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%;"|Generally expressed
|-
!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
|colspan="1" style = "background:#66e0ff;"|
|colspan="1" style = "background:#E6FAFF;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Expression may be seen
|colspan="1" style = "font-size:84%;"|
|-
|-
|colspan="1" style = "font-size:90%;" |CD11C
|colspan="1" style = "font-size:90%;" |CD11C
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "background:#E6FAFF;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|
|colspan="1" style = "font-size:84%;"|
|-
|-
|colspan="1" style = "font-size:90%;" |CD20
|colspan="1" style = "font-size:90%;" |CD20
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "background:#66e0ff;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Expect expression
|colspan="1" style = "font-size:84%;"|Expression retained in some cases
|-
|-
|colspan="1" style = "font-size:90%; color:black;" |CD23
|colspan="1" style = "font-size:90%; color:black;" |CD23
|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%;"|Infrequent but reported
|colspan="1" style = "font-size:84%;"|
|-
|-
|colspan="1" style = "font-size:90%; color:black;" |CD25
|colspan="1" style = "font-size:90%; color:black;" |CD25
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "background:#E6FAFF;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|
|colspan="1" style = "font-size:84%;"|
|-
|-
|colspan="1" style = "font-size:90%;" |CD43
|colspan="1" style = "font-size:90%;" |CD43
|colspan="1" style = "background:#66e0ff;"|
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Generally not expressed by LPL
|colspan="1" style = "font-size:84%;"|Generally not expressed by LPL
|-
|-
|colspan="1" style = "font-size:90%; color:black;" |CD79b
|colspan="1" style = "font-size:90%; color:black;" |CD79b
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "background:#66e0ff;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Generally expressed
|colspan="1" style = "font-size:84%;"|Expressed in some cases
|-
|-
|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%;"|
|colspan="1" style = "font-size:84%;"|
|-
|colspan="1" style = "font-size:90%; color:black;" |CD200
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Detected frequently|-|}
|-
|colspan="1" style = "font-size:90%; color:black;" |FMC7
|colspan="1" style = "background:#E6FAFF;"|
|colspan="1" style = "font-size:80%;"|
|colspan="1" style = "font-size:80%;"|Not expressed
|-
|-
|}
|}

Latest revision as of 18:09, 14 July 2023

  • PC.jpg


Background to flow cytometric diagnosis

Differentiation to plasma cells involves (in mast cases) the loss of typical pan B-cell markers and surface light chains. The expression of CD45 also differs both within and between cases making standard gating strategies difficult to apply. Cells are most often identified through their co-expression of CD138 with a relatively high expression of CD38, together with the absence of typical B-cell features.


Immunophenotype of plasma cells
CD45 expression
There is no consistent pattern of expression of CD45 although it is most often weak, but may be variable and is occasionally strong.
Major markers useful in plasma cell identification
Marker Freq Level Comment
CD38 - The relatively strong expression of CD38 is typical of plasma cells
CD138 var Expression is expected although the intensity can vary
κ/λ Surface light chain expression is lost (internal will be detected in permeabilised cells)
CD19 - Expression of CD19 may persist in some cases
Other relevant markers
CD5 - Not detected on plasma cells
CD10 -
CD11C -
CD20 - Expression retained in some cases
CD23 -
CD25 -
CD43 - Generally not expressed by LPL
CD79b - Expressed in some cases
CD103 -
CD200 - Detected frequently|-|}
FMC7 Not expressed


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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