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Updated: Feb 28, 2026
Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma
Published on: January 9, 2019
Diagnostic Algorithm of Common Mature B-Cell Lymphomas by Immunohistochemistry
Insights
Immunohistochemistry aids mature B-cell lymphoma diagnosis, but CD5 and CD10 markers lack specificity. A comprehensive panel of B-cell antigens is crucial for accurate identification of lymphomas and plasma cell neoplasms.
Area of Science:
- Hematopathology
- Oncology
- Immunohistochemistry
Background:
- Mature B-cell lymphomas and plasma cell neoplasms have distinct immunohistochemical profiles for diagnosis.
- However, many B-cell lymphomas share overlapping immunohistochemical features, reducing diagnostic specificity.
- Specific markers like cyclin D1 for mantle cell lymphoma exist but are rare.
Purpose of the Study:
- To review CD5 and CD10 expression in mature B-cell lymphomas.
- To analyze immunophenotypes of plasma cells in myeloma and lymphoma.
- To examine rare aggressive B-cell lymphomas with plasma cell antigen features.
Main Methods:
- Systematic review of published English literature.
- Literature search conducted via PubMed indexing.
Main Results:
- CD5 and CD10 expression is useful but not specific for B-cell lymphoma subtypes.
- Plasma cells in neoplasia and lymphoma show overlapping yet distinct immunophenotypes.
- CD138 is consistently positive in aggressive B-cell lymphomas with plasmablastic features.
Conclusions:
- Include CD5 and CD10 in initial lymphoma panels but use other B-cell antigens judiciously.
- A panel including CD19, CD45, CD56, and CD117 aids plasma cell identification.
- Aggressive B-cell lymphomas with plasmablastic features often show CD138 positivity.
Context:
- Different types of mature B-cell lymphomas, including plasma cell neoplasms, exhibit distinct immunohistochemical profiles, which enable them to be correctly diagnosed. However, except for rare examples of lymphoma-specific immunohistochemistry, such as cyclin D1 in mantle cell lymphoma and annexin A1 in hairy cell leukemia, immunohistochemical profiles of mature B-cell lymphomas overlap and lack specificity.
Objectives:
- To systemically review immunohistochemical features associated with commonly encountered mature B-cell lymphomas based on the presence or absence of CD5 and CD10; to review the immunophenotypic profile of plasma cells derived from plasma cell myelomas and B-cell lymphomas; and to review a group of rare, aggressive B-cell lymphomas with antigen expression features of plasma cells.
Data Sources:
- Published and PubMed-indexed English literature was reviewed.
Conclusions:
- Although the presence or absence of CD5 and CD10 expression should be included in the initial immunohistochemistry screening panel for mature B-cell lymphomas, appropriate and judicial use of other B-cell antigens is necessary to ensure correct diagnoses. Furthermore, although the status of CD5 and CD10 expression is associated with certain prototypes of B-cell lymphomas, their expression is not specific. Plasma cells from plasma cell neoplasias and B-cell lymphomas exhibit overlapping but relatively distinct immunophenotypes; thus, a panel of immunohistochemical markers (CD19, CD45, CD56, and CD117) can be employed for their proper identification. Lastly, CD138 staining results are almost always positive in a group of aggressive B-cell lymphomas with plasmablastic features, including plasmablastic plasma cell myeloma, plasmablastic lymphoma, and ALK-1+ large B-cell lymphoma.
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