I personnaly make the diagnosis of PLL based upon immunophenotype and morphology (with morphology being vital). Without morphology I would give a differential that is as specific as possible and discuss the probability of each possible diagnosis. Maryalice >From: "Michael Brown" <michael.brown@m.cc.utah.edu> >To: Cytometry Mailing List <cytometry@flowcyt.cyto.purdue.edu> >Subject: PLL and MCL phenotypes >Date: Fri, 12 May 2000 12:47:48 -0600 >X-Priority: 3 >X-PMFLAGS: 570950016 0 1 22906.CNM > >We recently have observed a few clinical leukemia cases that have >phenotypic patterns suggestive of mantle cell lymphoma, but with a >number of larger transformed cells that morphologically appear to be >prolymphocytes. From our experience, these two entities can have >similar, if not identical phenotypes (CD5+, CD19+, CD20+ >(mod-bright), FMC-7+, CD79b+, and mod-bright Ig light chains). >With approx. 30% of PLL retaining CD5 and most cases of PLL are CD23 >negative, my question is: > How are people signing out these cases? As we continue to >gain experience with FMC-7 and CD79b, we are finding them to be >variably expressed in different lymphoid malignancies. Are people >always signing out cases with a differential diagnosis, or is the >diagnosis more specific and pointed? Being in a reference >laboratory setting, getting adequate history or assessable >morphology is exceedingly rare. Thank you in advance for your >comments. > >Michael S. Brown, MD >Dept. of Pathology >University of Utah >ARUP Laboratories, Inc. > Maryalice Stetler-Stevenson Director Flow Cytometry Unit Laboratory of Pathology, NCI, NIH
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