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Updated: Aug 10, 2026
Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma
Published on: January 9, 2019
The utility of CD20 and CD43 in subclassification of low-grade B-cell lymphoma on paraffin sections
M J Contos1, M J Kornstein, D J Innes
1Department of Pathology, Medical College of Virginia, Richmond, USA.
Insights
CD43 is expressed in most low-grade lymphoproliferative disorders, except follicular small cleaved cell lymphomas (FSC). This finding aids in diagnosing these conditions using paraffin-embedded tissue.
Area of Science:
- Hematology
- Immunohistochemistry
- Oncology
Background:
- Low-grade lymphoproliferative disorders (LPDs) present diagnostic challenges.
- Immunophenotyping aids in differentiating these lymphoid neoplasms.
Purpose of the Study:
- To identify phenotypic differences among low-grade LPDs using immunohistochemistry.
- To evaluate the expression of CD43, CD5, and MT2 in various LPDs.
Main Methods:
- Studied 49 cases of low-grade LPDs, including follicular small cleaved cell lymphoma (FSC), small lymphocytic lymphoma (SL), lymphoma of intermediate differentiation (IDL), monocytoid B-cell lymphoma (MBC), and chronic lymphocytic leukemia (CLL).
- Utilized immunohistochemistry on paraffin-embedded tissues and cytospins to assess CD43, CD20, CD5, and MT2 expression.
- CD45RO (UCHL1) was used as a pan-T cell marker.
Main Results:
- CD43 was negative in all FSC cases but positive in most SL (85%), IDL (67%), MBC (50%), and CLL (86%).
- CD20 was positive in all studied LPDs.
- CD5 expression showed a pattern similar to CD43, with 77% of SL and CLL cases positive for both CD5 and CD20. All CD5-positive SL cases also expressed CD43.
- MT2 expression varied and was not helpful for differentiation. All cases were CD45RO negative.
Conclusions:
- CD43 is a useful marker for distinguishing FSC from other low-grade LPDs, as it is expressed in most LPDs except FSC.
- CD43 expression can be assessed in formalin-fixed tissues, making it advantageous over CD5 for diagnostic purposes.
- MT2 is not a reliable marker for differentiating these lymphoid neoplasms.
Abstract:
To identify phenotypic differences among the low-grade lympho-proliferative disorders in paraffin-embedded tissue, we studied 49 cases. All 22 follicular small cleaved cell lymphomas (FSC) were CD43 negative and CD20 positive. In contrast, of 20 small lymphocytic lymphomas (SL), 90% were CD20 positive, 85% were CD43 positive, and 75% were positive for both. Of three lymphomas of intermediate differentiation (IDL), two were CD20 positive and two were CD43 positive. All four monocytoid B-cell lymphomas were positive for CD20 and 50% (two cases) were positive for CD43. Some 86% of 14 chronic lymphocytic leukemias (CLL) (on cytospins) were positive for CD43; all nine of the CLL studied for CD20 were positive and 89% (8/9) expressed both antibodies CD5 expression (on frozen sections or cytospin preparations) was compared to CD43 in 21 cases of SL and CLL. Some 77% were positive for both CD5 and CD20. All seven of the CD5-positive SL also expressed CD43. The antibody MT2 was also examined with the following results: FSC, 16/20 (80%) positive; SL, 18/19 (94%) positive; MBC, 3/3 positive; and ILL, 2/3 positive. All 56 cases tested were CD45RO (UCHL1) negative. We conclude that CD43 is expressed on most cases of low-grade lymphoproliferative disorders with the exception of FSC. Its pattern of expression seems similar to CD5; however, unlike CD5, CD43 can be studied in formalin-fixed tissue. MT2 is not helpful in distinguishing among these lesions.
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