Hi, This could be either sc atypical CLL or mantle cell lymphoma. I would make a decision considering: cytology of the cells (are they "cleaved"?) and CD23 expression - dim? how large fraction of lymphoma cells is positive? The pattern of Follicle Dendritic Cells in the lymph node biopsy (if available) can also help in differential diagnosis. Best wishes Anna At 20:14 1999-10-15 -0400, you wrote: > >Hi all, > >We have a clinical case that's interesting to the point of frustration. Any >comments? > >53 y male, 3 years ago and now (recurrent) lymphoma, B-cell type. Phenotype is >similar in both flow cytometric studies: > >CD19+ CD20+ CD22 dim, CD5 dim before, partial now, CD25+, CD23 partial, CD11c >partial, with kappa light chain restriction. Negative for CD10. We do not stock >FMC7 (but will soon), CD21 or CD24. > >By morphology and flow (considering dim CD5 as negative), the diagnosis of >follicular center cell lymphoma (noting that 20-30% of these are known not to >express CD10) was made. None of us are entirely sure of that diagnosis now, and >there appears to be a tad more CD5 expression (recent specimen was FNA of >cervical node); it was suggested that this may be a mantle cell lymphoma. > >OK, simple enough - immunohistochemical stains bcl-2 and cyclin D1 should answer >that question. Those are difficult stains to optimize, however, and are affected >by variations in fixation. In other words, they didn't help much. CD20 nor kappa >light chain expression is remarkable for staining intensity, but I'd favor a CLL >based on the rest of the phenotype. The pathologists say small cell, low grade, >but not really CLL-like and definitely not PLL. > >?? Thanks for any discussion. > >sharon > >Sharon F. Vogt >svogt@bellsouth.net >Dekalb Medical Center >Atlanta, GA 30033 > > > > > > > Anna Porwit Heamatopathology Lab. Department of Pathology Karolinska Hospital, Stockholm anpo@mb.ks.se tel.:+46-851774518 fax.:+46-851775843
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