Melissa -- According to the FAB group (Bennett JM, et al, J. Clin. Pathol. 1989; 42:567-584), the incidence at which FMC7 is positive in >30% of cells in intermediate lymphocytic lymphoma (ie, Mantle Cell lymphoma) is 40-80%; in CLL, it is 10-40%. Our lab here in Scottsdale does not use FMC7; our panel resembles what Hugh Johnson has listed in his message earlier. We found that the addition of CD23 sometime ago has facilitated identification of early (leukemic) presentations of MCL (CD5+/CD23-). These cases probably account for as many as 5-10% of our clonal B cell lymphoid leukemia patients. I would, however, add something to what Maryalice and Hugh have stated: the relative *intensity* of sIg and CD20 expression can be extremely helpful in distinguishing between MCL and CLL. MCL (and other NHL) are typically bright CD20+ and bright kappa (or lambda) positive, while CLL shows dim/weak expression for these markers. What do some other folks have to say about panels in the workup of chronic lymphoid leukemias? (Randy Gascoyne? Curt Hanson?) *************************************************************** Christopher R. Conley, MD conley.christopher@mayo.edu Dept. of Pathology Tel:(602)301-8021 FAX:(602)301-8372 Mayo Clinic Scottsdale 13400 E. Shea Blvd. Scottsdale AZ 85259
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