Immunophenotype of common clonal B-cell disorders
| . | CD5 . | CD19 . | CD20 . | CD23 . | CD10 . | CD103 . | Dual CD11c/22 . | sIg . | CD200 . | Genetic defects . |
|---|---|---|---|---|---|---|---|---|---|---|
| CLL | + | + | Dim | + | − | − | − | Dim | + | — |
| MCL* | + | + | Bright | Dim/− | − | − | − | Bright | − | t(11;14) |
| FL | − | + | + | +/− | +/− | − | − | + | − | t(14;18) |
| MZL† | − | + | Bright | − | − | − | + | + | − | 7q− |
| HCL | − | Bright | Bright | − | − | + | Bright | + | + | — |
| LPL‡ | +/− | + | + | +/− | − | − | − | Dim | + | — |
| . | CD5 . | CD19 . | CD20 . | CD23 . | CD10 . | CD103 . | Dual CD11c/22 . | sIg . | CD200 . | Genetic defects . |
|---|---|---|---|---|---|---|---|---|---|---|
| CLL | + | + | Dim | + | − | − | − | Dim | + | — |
| MCL* | + | + | Bright | Dim/− | − | − | − | Bright | − | t(11;14) |
| FL | − | + | + | +/− | +/− | − | − | + | − | t(14;18) |
| MZL† | − | + | Bright | − | − | − | + | + | − | 7q− |
| HCL | − | Bright | Bright | − | − | + | Bright | + | + | — |
| LPL‡ | +/− | + | + | +/− | − | − | − | Dim | + | — |
It is important to look at the flow cytometry histograms to determine the intensity of expression and whether the staining is “all, none, or partial.” The immunophenotype profile of classic CLL is dim sIg and dim CD20; CD5 and CD23 expression (not partial expression for either) is critical. Some degree of immunophenotype overlap among CLL, marginal zone lymphoma, and lymphoplasmacytic lymphoma exists. If the diagnosis is uncertain based on peripheral blood flow cytometry, lymph node biopsy should be pursued.
CD23 is usually negative, but ∼20% of cases will have partial CD23 expression.
CD5 is positive in 10% to 20% of cases, and it may be bright or partial in these situations.
20% of cases are CD5+; CD23 is usually negative, but some cases will have partial CD23 expression.
FL, follicular lymphoma; HCL, hairy cell leukemia; LPL, lymphoplasmacytic lymphoma; MZL, marginal zone lymphoma; sIg, surface immunoglobulin