burkitt or non-burkitt
ctnebe (ctnebe@t-online.de)
Mon, 21 Oct 96 23:51 +0100
Maryalice Stetler-Stevenson reported on a case that was considered to be a
non-hodgkin lymphoma. Obviously there was a remarkable negativity for nearly
all lymphoid and hematological markers. What are the possible explanations?
As there are no clinical informations, I guess that the clinicians suspicion was
not only based on the L3 morphology (Burkitt) but also on positive lymph nodes
and other signs of NHL.
>From the marker result a plasmocytoma would be possible that is CD45 negative
and CD38 positive. We would expect CD56 and BB4 in addition. The negativity for
cytoplasmic Ig is against that diagnosis in case you are using
(hopefully) polyclonal reagents. The electrophoresis pattern should give a
strong hint.
Another explanation would be that the tumor (?) is of non hematopoietic origin
however then he is unlikely to be highly leukemic.
A third explanation is that the reagents were all far below saturation and CD38
was high enough concentrated.
Dr. Loeffler from Kiel in Germany has shown one AML with a Burkitt like
morphology, however these you expect to show either CD13, CD33 or CDw65 and
myeloperoxidase. This is however a rare case.
It might be a good idea in such cases to prepare several unstained blood films
that allow for a later processing.
In summary a plasmocytoma with incomplete phenotype and so called mott cells has
the highest probability assuming that your lab is experienced in doing proper
immunophenotyping. I would be glad to review the blood film if you like.
Thomas Nebe, Klinikum Mannheim, Zentrallabor
D-68135 Mannheim, GERMANY
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