Re: Clinical case

From: anpo@fafner.mb.ks.se
Date: Wed Dec 08 1999 - 03:12:53 EST


Hi,
CD5+ has been reported in about 5-10% of HCL. There are also (rare) cases
of splenic lymphoma with villous lymphocytes that can express CD5, CD11c
and CD103 - this diagnosis seems most probable in this case. Have you done
cytochemistry for tartrate resistant acid phosphatase? Should be negative
in mantle but positive in HCL and SLVL.
Some relevant references:
Blood 1994 Mar 15;83(6):1558-62 
Blood 1994 Jun 15;83(12):3672-81 
Leuk Lymphoma 1994;14 Suppl 1:57-61 
Hematol Pathol 1994;8(3):99-109 
Am J Hematol 1996 Apr;51(4):282-8 
Best wishes
Anna

At 17:31 1999-12-06 -0800, you wrote:
>
>Colleagues:
>
>We analyzed blood from an 88 year old man with a white count of 357,000,
>97% lymphs, many atypical lymphs.  Hgb is 9.3, platelets 139,000.  We
>performed our usual r/o CLL panel and obtained the following results:
>CD19+CD20 very bright+CD5+CD43+CD23-FMC7+lambda bright+.  Sounds like a
>straightforward mantle cell.  
>
>The pathologist was puzzled by the morphology and raised the specter of
>hairy cell leukemia (which he thought was low probability), so we did
>CD103, CD11c, and CD25, expecting them to be negative.  Not so.  CD103 and
>CD11c are both nicely positive.  CD25 is dim+.  At this point, we have no
>further clinical info.  
>
>Does anyone have any data on expression of CD103 and 11c in mantle cell or
>prolymphocytic leukemias?  Do you have any further thoughts on this case?
>
>Thanks 
>
>Irene
>
Anna Porwit
Heamatopathology Lab.
Department of Pathology
Karolinska Hospital, Stockholm
anpo@mb.ks.se
tel.:+46-851774518
fax.:+46-851775843



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