Tough CLL case

Anja Porwit Anja.Porwit at
Thu Sep 7 02:18:35 EST 2000

Hi Sharon,
we had this summer an interesting discussion concerning these cases, there
obviously is a grey zone between CLL/SLL/mantle. There was even a proposal
to start a register of these cases.
Conclusion was that the way to prove that it is a mantle would be to show
t(11;14) or cyD1 overexpression. By immunophenotype mantle NHL are usually
CD20 bright, FMC7 + and express sIg bright so the phenotype in your case is
not quite characteristic for mantle. Also, the fluorescence intensity of
CD23 varies considerably in CLL cases.
Best wishes

At 10:31 2000-09-06 +0100, you wrote:
>Hi folks,
>We had an interesting CLL/SLL the other day: CD19+ CD20dim CD5+ CD22dim
>FMC7neg, lambda light chain dim, CD11c+, CD38neg, _but it was CD23neg_. At
>most, one might call the CD23 partial, but it was in no way obviously
>positive. We sent the case out for consult and it was, again, determined to
>be a CLL. The specimen was a lymph node, 56yr M, peripheral blood
>lymphocytosis: WBC 9.2, lymphs 73%, RBC 3.5, Hct 35. I would have run the pb
>if I'd been able to get my hands on it. Might the cells have been more
>positive for CD23 in the pb environment?
>A subsequent bone marrow biopsy went to a reference lab for flow cytometry.
>That specimen was interpreted as being involved with mantle cell lymphoma.
>Now the oncologists aren't sure who to believe. I'm trying to get the plots
>from the other lab and this will all go to tumor board/review on Monday.
>I'm looking for some comments from you all. I'd be more than happy to fax
>plots to anyone who is interested in seeing them. Sort of like an unofficial
>(free) consult. Anyone?  :]
>Thanks very much,
>Sharon F. Vogt
>Dekalb Medical Center
>Atlanta, GA
>404-297-0444 fax
Anna Porwit
Hematopathology Lab.
Department of Pathology
Karolinska Hospital, Stockholm
Anja.Porwit at

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