Related Experiment Video
Updated: May 4, 2026
Immunoglobulin Gene Sequence Analysis In Chronic Lymphocytic Leukemia: From Patient Material To Sequence Interpretation
Published on: November 26, 2018
[Immunophenotyping of B chronic lymphoproliferative syndromes (CLL excluded): confrontation with the histology]
Wijden El Borgi1, Nawel Ben Salah1, Fatma Ben Lakhal1
1Service d'hématologie biologique, Hôpital Aziza Othmana, Tunis, Tunisie.
Insights
Flow cytometry (CMF) has limited utility in classifying non-chronic lymphoid leukemia (CLL) B-cell lymphoproliferative syndromes (B-CLPS). Only hairy cell leukemia (HCL) shows a characteristic immunophenotype, making histology essential for accurate diagnosis.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Immunophenotyping via flow cytometry is crucial for diagnosing chronic lymphoid leukemia (CLL).
- Its role in classifying other B-cell lymphoproliferative syndromes (B-CLPS) is less defined.
- Accurate classification of non-CLL B-CLPS is essential for appropriate patient management.
Purpose of the Study:
- To evaluate the diagnostic and classification utility of flow cytometry (CMF) for non-CLL B-CLPS.
- To compare CMF findings with histological diagnoses in these conditions.
- To determine the specific B-CLPS subtypes where CMF is most effective.
Main Methods:
- Analysis of 28 cases of non-CLL B-CLPS, excluding those with a Matutes score of 4 or more.
- Flow cytometry (CMF) was performed to assess B-cell populations and antigen expression.
- Results were compared and correlated with histological findings for definitive diagnosis.
Main Results:
- CMF identified monoclonal populations in 28 cases (15 kappa, 13 lambda).
- CD5 co-expression (CD19+CD5+) was observed in 11 cases, suggesting atypical CLL or mantle cell lymphoma.
- Hairy cell leukemia (HCL) showed a characteristic immunophenotype (CD11c+, CD103+), confirmed by histology. Other diagnoses included marginal zone lymphoma, SLVL, follicular lymphoma, and prolymphocytic leukemia.
Conclusions:
- Flow cytometry (CMF) is insufficient for classifying most non-CLL B-CLPS.
- The immunophenotype of hairy cell leukemia (HCL) is distinctive and reliable.
- Histological examination remains indispensable for the accurate diagnosis and classification of non-CLL B-CLPS.
Abstract:
Immunophenotyping is a major tool for the diagnosis of the chronic lymphoïd leukaemia (CLL). Its interest remains limited in the classification of the other B chronic lymphoproliférative syndromes (B-CLPS). We evaluate the place of the flow cytometry (CMF) in the diagnosis and classification of the non CLL B-CLPS. The cases with Matutes score of 4 or more are excluded. A confrontation of the results to the histology is made. 28 cases of non CLL B-CLPS are diagnosed. CMF shows a κ monoclonal population in 15 cases and λ in 13 cases. A co-expression CD19+CD5 + is found in 11 cases concording with an atypic CLL or a mantel cell lymphoma in 6 cases with Matutes score of 3. In 5 cases, we concluded to non CLL B-CLPS (Matutes<3). The histology retained the diagnosis of a mantel cell lymphoma (4 cases), a SLVL (1 case) and an atypical LLC (1 case). CD5 is negative in 17 cases. In 5 cases, the diagnosis of hairy cell leukemia (HCL) is retained (CD 11c+ CD103+) and confirmed by the histology. The diagnosis of a marginal zone lymphoma is retained in 2 cases, a SLVL in 2 cases, a follicular lymphoma in 3 cases and prolymphocytes leukaemia in 1 case. Nine cases of non CLL B-CLPS were difficult to classify by histology. CMF is insufficient for the classification of most of the non CLL B-CLPS. Only the phenotype of the HCL is characteristic. The confrontation of the histology results remains essential.
