interesting clinical case

Anja Porwit Anja.Porwit at
Fri Sep 22 04:24:50 EST 2000

The phenotype you describe could be consistent with immunocytoma/marginal
cell lymphoma. Morhologically the cells can have lymphoplasmocytoid aspect.
If your patient has a WBC of 16 with 11% ly - what are other cells?
Kind regards

At 10:44 2000-09-21 -0400, you wrote:
>A PB was sent to our lab for lymphoma/leukemia immunophenotyping. The
>patient is a 70 year old man with a history of CLL. His total white count
>was 16,000 with a lymphocyte count of  11%. Here is what we found on flow:
>CD45 bright, CD20 bright ( 70% ), Lambda bright ( 60% ), Kappa 0%, CD19+,
>CD22 Dim+ ( 65% ), CD23 Dim+ ( 55% ), FMC7 dim+, CD11c-, CD10-, CD43- ( on
>B-cells ), CD5- ( on B-cells ). So in summary, the patient has no
>coexpression of CD5 and CD19 as well as CD5 and CD20, has bright CD20 and
>Lambda restriction, is CD23+ , CD10-. My question is: does this patient have
>a variant of CLL, a CLL/PLL transformation, or a lymphocytoid leukemia? The
>CD5 negativity and bright CD20 is not the standard pattern of CLL, and the
>lack of FMC7 bright positivity doesn't go with PLL. Any insights from the
>experts? Morphologically, the cells could be prolymphocytes but the
>pathologist is not sure.
Anna Porwit
Hematopathology Lab.
Department of Pathology
Karolinska Hospital, Stockholm
Anja.Porwit at

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