In my experience CD5+23+19+ & generally (but not exclusively) reduced
intensity light chain helps key out a CLL by immunophenotype. The absence
of CD23 expression with the same immunophenotype (and more light chain
expression) would suggest a mantle cell. I have not personally found FMC7 a
very useful reagent.
regards
frederic preffer
At 06:44 PM 6/12/97 -0500, you wrote:
>
>
>Melissa --
>
>According to the FAB group (Bennett JM, et al, J. Clin. Pathol. 1989;
>42:567-584), the incidence at which FMC7 is positive in >30% of cells in
>intermediate lymphocytic lymphoma (ie, Mantle Cell lymphoma) is 40-80%; in
>CLL, it is 10-40%.
>
>Our lab here in Scottsdale does not use FMC7; our panel resembles what Hugh
>Johnson has listed in his message earlier. We found that the addition of CD23
>sometime ago has facilitated identification of early (leukemic) presentations
>of MCL (CD5+/CD23-). These cases probably account for as many as 5-10% of our
>clonal B cell lymphoid leukemia patients. I would, however, add something to
>what Maryalice and Hugh have stated: the relative *intensity* of sIg and CD20
>expression can be extremely helpful in distinguishing between MCL and CLL.
MCL
>(and other NHL) are typically bright CD20+ and bright kappa (or lambda)
>positive, while CLL shows dim/weak expression for these markers.
>
>What do some other folks have to say about panels in the workup of chronic
>lymphoid leukemias? (Randy Gascoyne? Curt Hanson?)
>
>***************************************************************
>Christopher R. Conley, MD conley.christopher@mayo.edu
>Dept. of Pathology Tel:(602)301-8021 FAX:(602)301-8372
>Mayo Clinic Scottsdale 13400 E. Shea Blvd. Scottsdale AZ 85259
>
>
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Dr. Frederic I. Preffer
preffer@helix.mgh.harvard.edu
Department of Pathology- Warren 525A
100 Blossom St
Massachusetts General Hospital
Boston MA 02114
v(617) 726-7481 fax(617) 724-3164