Re: atypical B-cell population

From: Frederic Preffer (preffer@helix.mgh.harvard.edu)
Date: Tue Dec 12 2000 - 09:43:11 EST


Andrea

We dont regularly use  CD22, but I strongly suspect that the 'brighter' CD20
cells you see would be dimly CD10+ [especially if you use PE conjugate] and
CD23- , whereas the dimmer CD20 cells would be CD10- and CD23+.  The CD22
surface staining is generally coordinate with the CD23 staining. I see this
all
the time in lymph nodes, and your immunophenotypic and light scatter
description follows a perfect scheme of B cell nodal maturation [CD19+ cells
that down regulate CD10 and upregulate CD20, 23 and 22 along with sIg]. I have
had no evidence to suggest this is related to any kind of premalignant state.
if you permeabilize the 'brighter' CD20 cells you can sometimes discern
polyclonal immunoglobulin light chain expression.

F Preffer



At 03:51 PM 12/8/00 -0500, Andrea Illingworth wrote:
>
> We have had quite a few lymph node cases which showed a bimodal distribution
> of CD20 and CD22. One population of cells shows expected antigen density of
> CD20 and CD22.  The second population shows brighter CD20 and slightly
dimmer
> CD22 expression (same CD45 intensity as the normal cells).  BAckgating of
> this population shows these cells to have increased light scatter.
Gating on
> these larger cells (by light scatter) shows they are kappa and lambda
> negative.
> Initial gating is done on the CD45+ cells by SS vs CD45-TC.
> Histolopathology is often normal, and other times atypical (but not
enough to
> call it malignant).
>
> What are these cells?  Are these cells some sort of normal, B-cells with
> neither kappa or lambda? Or do they represent a possible pre-malignant
state?
> How do you (if you have seen this scenario) report this out?
>
> Thanks in advance
>
> Andrea Illingworth
> Dahl-Chase Diagnostic Services
> Flow Cytometry
> Bangor, Maine



Frederic I. Preffer
Department of Pathology
Charlestown Navy Yard- 7140
Massachusetts General Hospital East
Charlestown, MA 02129

voice     [617] 726-7481
fax        [617] 724-3164



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