We have had quite a few confirmed follicular lymphomas that are
CD10 negative. These patients have had a clinical course appropriate for
follicular lymphoma and histology classic for the disease so I don't
consider CD10 negativity as excluding follicular lymphoma. I feel it is
dangerous to assign a histological diagnosis using immunophenotype unless
there is a classic and distinctive immunophenotype. In the setting of
indistinct histology and immunophenotype (this could be other clinical
categories such as marginal zone lymphoma which can be CD11c negative), I
would just indicate B-cell neoplasia (assuming of course there is no
clinical history that would indicate could have non-neoplastic monoclonal
B-cell population). What does the atypical infiltrate in the bone marrow
look like? Is it diffuse or clustered and paratrabecular? Does the patient
have an enlarged spleen or lymph nodes? Sounds like you are going to have
to put together the clinical and histological data with your
immunophennotypic data to come up with the best guess (as usual). If you
can demonstrate a t(14;18) that might help in a small cleaved cell
population. Good luck and let us know if you find anything further.
Maryalice
>Happy year year to one and all.
>
>I have a bone marrow biopsy on a 63 yr old male with severe peripheral
>pancytopenea. Biopsy is atypical lymphoid infiltrate consistent with NHL
>small cleaved cell. Light scatter shows a single population of small
>lymphocytes. The phenotype is CD5-, CD19+, CD22+, CD10-, CD20+, CD25-,
>CD23-, CD103-, CD11c-, kappa bright positive, lambda negative. Seems to fit
>best with follicular lymphoma except for the CD10 negativity. I wonder what
>others of you may think about this phenotype?
>
>Thanks,
>
>Brent Dorsett
>Director, Special Pathology Laboratories, Lenox Hill Hospital, NYC
Maryalice Stetler-Stevenson
Director Flow Cytometry Unit
Laboratory of Pathology, NCI, NIH
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