A 55 year old female had a history of follicular low grade lymphoma in 1989. She now presents with ascitis and abdominal nodes. The cells show a similar picture: a mixture of small cleaved and predominantly large cells. The large cells have characteristics of centrocytes or centroblasts. Many have abundant cytoplasm which in giemsa stain is blue with vacuoles. There sre also a few giant bizarre multinucleated ones. They are proliferative and express p53 strongly. Phenotypically the lymph node is CD5-, CD10+/20+, CD19weak, CD22+, CD23-, monoclonal Kappa strong, I3 strong. T cell markers are negative. The ascitic fluid(many very large cells) demonstrates much the same except that CD5 is definitely coexpressed with CD20 and CD23 is weak fluorescence. Does this represent the same clone? Does expression of CD5 depend upon geographical environment? Any suggestions?? I sent this earlier but had no responses. Hopefully someone will be able to comment on this phenotypic presentation. Thank you. -- Dr. Ken Orr, Head Immunology St. Boniface General Hospital 409 Tache Avenue, Winnipeg, Manitoba R2H 2A6 Tel: (204) 237-2482 Fax: (204) 235-3423
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