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Published on: October 23, 2019
CD200 expression may help in differential diagnosis between mantle cell lymphoma and B-cell chronic lymphocytic
Giuseppe A Palumbo1, Nunziatina Parrinello, Giovannella Fargione
1Department of Biomedical Sciences, Hematology Section, University of Catania, Italy. ga.palumbo@ematologiacatania.it
Insights
CD200 expression helps differentiate chronic lymphocytic leukemia (B-CLL) from mantle cell lymphoma (MCL). B-CLL cells consistently express CD200, while MCL cells typically do not, aiding in diagnosis.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Chronic lymphocytic leukemia (B-CLL) and mantle cell lymphoma (MCL) present diagnostic challenges, particularly in leukemic phases.
- Current diagnostic markers like CD23 are useful, but cyclin D1 immunohistochemistry can be equivocal in MCL.
- CD200, an immunoglobulin superfamily member, is expressed on B-CLL cells.
Purpose of the Study:
- To evaluate the diagnostic utility of CD200 expression in distinguishing B-CLL from MCL.
- To assess CD200 expression in fresh neoplastic cells and tissue samples from B-CLL and MCL patients.
Main Methods:
- Flow cytometry was used to analyze CD200 expression on fresh leukemic cells from 93 patients (79 B-CLL, 14 MCL).
- Immunohistochemistry was performed on paraffin-embedded lymph node and bone marrow biopsies from 23 B-CLL and 44 MCL patients.
Main Results:
- All evaluated B-CLL samples (fresh cells and tissues) demonstrated CD200 positivity.
- MCL cells showed absent or minimal CD200 expression (in a small minority of cells in 3 cases).
- CD200 expression was consistently observed in B-CLL but absent in MCL across both fresh and tissue samples.
Conclusions:
- CD200 is a highly reliable marker for differentiating B-CLL from MCL.
- Incorporating CD200 into routine diagnostic panels can aid in excluding MCL diagnosis.
- CD200 expression offers a valuable tool for improving diagnostic accuracy in lymphoproliferative disorders.
Abstract:
Chronic lymphocytic leukemia (B-CLL) and mantle cell lymphoma (MCL) share many features and their differential diagnosis may be challenging, especially when a leukemic picture alone is present. Monoclonal antibody panels are often useful, with CD23 being the most reliable. However, MCL diagnosis should be confirmed by immunohistochemical cyclin D1 detection, sometimes with equivocal or even negative results. Other cytofluorimetric, cytogenetics or molecular techniques are reliable but not widely available. B-CLL leukemic cells express CD200, a membrane glycoprotein belonging to the immunoglobulin superfamily. We investigated its expression on fresh neoplastic cells of 93 patients with a CD5+ lymphoproliferative disease (79 selected B-CLL and 14 MCL in leukemic phase). Although these data cannot be generalized, all B-CLL samples we examined were positive, with CD200 present on the vast majority of the cells while, in MCL patients, CD200 was expressed by a small minority of CD5+ cells in three subjects and totally absent in the remaining 11. We then examined CD200 expression on paraffin-embedded lymphoid tissues and bone marrow (BM) trephine biopsies from 23 B-CLL and 44 MCL patients. Again, all B-CLL cells were CD200+ both in lymph nodes and in BM while all MCL cells were negative. Adding CD200 in routine panels could be of diagnostic utility in excluding MCL diagnosis.
