Dear Tom,
Interesting coincidence. We saw a similar case last week. The bone
marrow of a patient with a clinical hipotesis of Waldenstrom showed
positivity for CD38, CD20, CD117, CD45dim, CD71dim and kappa in the surface,
but lambda in the cytoplasm.
Like you, due to these confusing results, we also asked for another
sample and all the results were confirmed. Your questions are ours.
Thanks for sharing the case.
Jorge Neumann
Santa Casa Hospital
Porto Alegre, Brasil
>
> -----Mensagem Original-----
> De: Tom Sawyer <TSAWYER@MCO.EDU>
> Para: Cytometry Mailing List <cytometry@flowcyt.cyto.purdue.edu>
> Enviada em: Quarta-feira, 6 de Setembro de 2000 14:18
> Assunto: A very strange case of HCL!
>
>
> >
> > Greetings All, I normally don't try to bother you folks with unusual
cases
> but we have
> > had one that I would like to share and inquire about as it has us very
> puzzled. We
> > recently had a patient with a diagnosis of Hairy Cell Leukemia. His
> phenotype was
> > classic HCL with the exception of CD23 positivity. The cells were
strongly
> positive
> > for lambda surface light chains. However, he demonstrated monoclonal
> kappa IgM
> > by immunoelectrophoresis. We were concerned that an error may have
> occured in the
> > immunophenotyping and requested a new specimen. Repeat analysis again
> demonstrated
> > monoclonal lambda surface light chains. We then proceeded to measure
> cytoplasmic light
> > chains and found the cells in question to have a cytoplasmic kappa pool
as
> well lambda.
> >
> > I have two questions:
> >
> > 1. Has anyone ever seen this before?
> >
> > 2. Is it theoretically possible for leukemic cells to express one type
of
> light chain
> > on the surface and be synthesizing and secreting the other?
> >
> >
> > Thanks, Tom
>
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