Flow Cytometry > Phenotypic Markers > Flashcards

Phenotypic Markers Flashcards

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1
Q

What diagnosese can

TdT be positive in ?

A
  • B-ALL
  • T-ALL
  • Thymocytes
    • thymic hyperplasia
    • thymoma
  • AML
  • Blastic plasmacytoid dendritic cell neoplasm (BPDCN)
  • Hematogones
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2
Q

What type of molecule is TdT ?

A
  • it is a unique intranuclear DNA polymerase
  • in AMLs usually seen in
    • minimally differentiated
    • or rarely monoblastic leukemias
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3
Q

What diseases is MPO positive in ?

A
  • AML
  • Mixed phenotypic acute leukemia (MPAL)
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4
Q

What is the threshold for MPO positivity ?

A
  • 3% threshold has been used historically for cytochemistry
  • 10% threshold has been recommended for flow cytometry
    • recent proposal for 13-28% positivity
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5
Q

Is there MPO positivity in B-ALL ?

A
  • yes there can be without it being classified as an MPAL
  • if there is homogeneous expression of lymphoid markers on the single blast population and there is no evidence of other myeloid marker expression othere than MPO
  • B-ALL has been known to show low levels of MPO expression
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6
Q

What populations is HLA-DR positive in?

A
  • expressed on B cells at different stages of maturation
    • except in plasma cells where it is lost
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7
Q

What is HLA-DR negative in ?

A
  • hematopoietic progenitor cells
    • myeloid
    • erythroid
    • megakaryocytic
    • monocytic/macrophage
  • Hypo and hypergranular APL
  • Plasma cell neoplasms
  • Majority of T cell lymphoma/leukemias
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8
Q

What malignancies are typically

HLA-DR positive ?

A
  • HLA-DR is positive on precursors and mature B cell lymphoproliferations
  • majority of AML
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9
Q

CD235a (glycophorin A) is positive

in which cell populations?

A
  • expressed on RBCs and their precursors
  • very early precursors are usually negative or only dimly positive
    • IMP:
      • this is in contrast to CD71
      • CD71 is strongly expressed by even the early precursors
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10
Q

CD138 is positive in what situations ?

A
  • majority of plasma cell neoplasms
  • subsets of mature B cell lymphoproliferations
    • Plasmablastic lymphoma
    • DLBCL with activated B cell like phenotype
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11
Q

What malignancies is CD123

positive in ?

A
  • Blastic plasmacytoid dendritic cell neoplasm (BPDCN)
  • Benign plasmacytoid dendritic cells
  • AML (subsets)
  • APL (subset)
  • CMML
  • B-ALL (subset)
  • Hairy cell leukemia (bright)
  • Hairy cell leukemia variant (subset)/lower intensity of expression
  • NK-cell malignancies
  • Dendritic cell malignancies
  • MDS blasts may be CD123+
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12
Q

What is the normal role of CD123 ?

A
  • CD123 binds to the alpha subunit of the interleukin-3 receptor
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13
Q

When CD123 is positive in AML

what should you suspect is present ?

A
  • usually NPM1 positive
  • also positive in monoblastic leukemias
  • the leukemias are also positive for FLT3-ITD mutations and show low expression of CD34
    • positive for CD11b and CD14

Note: CD123 is positive in a subset of APL

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14
Q

What is the expected expression

of CD123 in HCL?

A
  • expression of CD123 is bright
  • Other rare cases of mature B cell lymphomas with CD123 (but expression is usually partial or dim)
    • HCLv (~40% of cases)
    • splenic marginal zone
    • CLL
    • MCL
    • FL
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15
Q

What disease processes can have

CD123+ associated plasmacytoid dendritic cells?

A
  • seen in the bone marrows of patients with CMML
  • lymph nodes with Kikuchi-fujimoto lymphadenopathy
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16
Q

What type of B-ALL can you

see expression of CD123 ?

A
  • usually hypodiploid B-ALL
  • IMP
    • normal bone marrow hematogones are negative for CD123
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17
Q

What benign cells are positive for CD117?

A
  • Myeloblasts
  • Promyelocytes
  • Mast cells
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18
Q

Which leukemias are typically

positive for CD117?

A
  • most AMLs are CD117 positive
    • even AML without maturation
    • AMML
    • pure erythroid leukemias
    • acute megakaryoblastic leukemia
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19
Q

What leukemias are typically

negative for CD117 ?

A
  • acute monoblastic leukemia
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20
Q

What other hematopoietic tumors are

positive for CD117 ?

A
  • Mast cell proliferations
  • plasma cell neoplasms
  • subsets of T-ALL
    • especially ETP-ALL
  • rare cases of mature CD8+ peripheral T cell proliferations
    • notably T-PLL
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21
Q

What non-hematopoietic things

are positive for CD117 ?

A
  • GIST
  • occasionally malignant melanomas
  • poorly differentiated caricnomas/neuroendocrine tumors
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22
Q

What are the 3 maturational stages of dendritic cells based on the expression of CD34 and CD117?

A
  • immature cell (CD34+)
  • intermediate cell (CD117+/CD34-)
  • mature cells (CD117-/CD34-)

Note: these maturational stages explain the different presentations of BPDCN

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23
Q

What benign cells are positive for CD103?

A
  • minor subset of T-cells in the GI tract and liver
  • dendritic cells, subset
  • rare circulating B cells
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24
Q

What neoplasms is CD103 expressed in ?

A
  • HCL
    • may be dim and or partial
  • HCL(v)
    • may be dim and or partial
  • Enteropathy associated T-cell lymphoma (EATL)
  • MEITL
  • Diffuse large B cell lymphoma (rare cases)
  • Marginal zone lymphoma (occasional cases)
  • rare cases of PTCL, ATLL, and T-PLL
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25
What other tumors may express CD103?
- BPDCN, subset
26
What neoplasms are negative for CD103 ?
* MCL * FL * CLL * MZL * including splenic marginal zone lymphoma
27
What normal cells express CD79a ?
* benign, B cells * this includes plasma cells which are essentially terminally differentiated B cells
28
What can pick up CD79a staining in a non-specific manner in the BM ?
* megakaryocytes
29
What neoplaasms are often positive for CD81 ?
* mature B cell proliferations
30
What normal cells and neoplasms is CD71 positive in?
* early erythroid precursors * pure erythroid leukemia * AML * B-ALL subset * T-ALL subset * High grade B and T cell lymphomas
31
What benign cells express CD71 (transferrin receptor)?
- B and T cell precursors - Myeloblasts - Activated B and T/NK cells - Erythroblasts/Pronormoblasts - Germinal center B-cells (centroblasts) - Reactive follicular hyperplasia (CD10+ B cells are CD71+)
32
What is the normal function of CD71 ?
* it is the transferrin receptor * it mediates the uptake of transferrin-iron complexes
33
What normal cells express CD71 ?
* strongly positive in erythroid precursors * myocytes * hepatocytes * endocrine pancreas cells * spermatocytes * basal keratinocytes * placental syncitiotropholblasts
34
How is the expression of CD71 compared to glycophorin A?-
- CD71 is positive in early precursors while negative on mature red blood cells
35
What is the expression pattern of CD71 in erythroid precursors ?
* strongly positive in early precursors * level of expression decreases gradually through the reticulocyte stage * this is contrast to glycophorin (CD235a), CD71 is negative in mature erythrocytes * CD71 has a similar expression pattern to E-cadherin
36
How does the intensity of CD71 vary amongst lymphomas?
* CD71 is low intensity in low-grade lymphomas * while it is high intensity in high grade lymphomas * Note: expression is higher in DLBCL as compared to Burkitt lymphoma
37
What is the expression of CD71 in the BM and why ?
* CD71 is expressed at a higher level on cells that have a high proliferation rate (due to high iron demand) * myeloblasts, promyelocytes, and erythroblasts are CD71+ * more mature forms are negative
38
CD71 is expressed more inT-ALL or B-ALL?
* usually more common in T-ALL * also IMP * ATLL shows some expression
39
What can CD71 be a surrogate marker for by flow cytometry ?
* it can be a surrogate for Ki67 * or a proliferation marker
40
How is CD71 expression affected in dysplasia?
- The expression of CD71 is decreased in dysplastic erythroid precursors
41
In bone marrow specimens how is CD71 expressed?
- CD71 expression is restricted to the erythroid lineage Note: myeloblasts, neoplastic plasma cells and metastatic carcinoma cells are usually negative.
42
What is CD64 expressed in ?
* monocytes (classical, CD14 bright +/CD16 -) * acute monoblastic leukemia * CMML * monocytic components of AMML * blasts in subsets of AML * APL, subset dim partial * Acute megakaryoblastic leukemia
43
What is different about the expression of CD64 in acute monocytic leukemias vs. others ?
* CD64 is brighter * in other AMLs the expression is dim or partial
44
What is CD61 expression seen in?
* megakaryocytes * Acute megakaryoblastic leukemia
45
What is CD57 expression seen in?
* NK cells and a subset of T cells * Positive in: * T-LGL leukemia * subset of NK-cell neoplasms * rare T cell lymphoblastic tumors * T-PLL, rare (mostly dim and partial) * Chronic LPD of NK cells
46
Where are the CD57+ T cells in NLPHL ?
* they form characteristic rosettes around the large neoplastic cells
47
What non-hematopoietic tumors can express CD57?
- Primitive Neuroectodermal Tumor (PNET) - Rhabdomyosarcoma - Small cell carcinoma
48
What is CD56 and what cells typically express it ?
* neural cell adhesion molecule (N-CAM) * expressed by natural killer cells, subsets of T cells, and monocytes
49
When can CD56 expression be unregulated?
- subsets of granulocytes and monocytes from patients with MDS, MPNs and mixed MDS/MPN (such as CMML)
50
What non-leukemic, hematolymphoid neoplasms express CD56?
* Extranodal NK/T cell lymphoma, nasal type * Peripheral T cell lymphoma, NOS (subset) * T-LGL leukemia (subset) * NK-cell proliferations *Chronic lymphoproliferative disorder of NK cells * ALCL (subset) * Subcutaneous panniculitis-like T cell lymphoma (subset) *Primary cutaneous gamma delta T cell lymphoma *HSTL * MEITL * EITL, subset * Lymphomatoid papulosis (LyP) * DLBCL (rare cases) * Plasma cell myeloma
51
What leukemia's often express CD56 ?
* acute monoblastic leukemia * acute myeloid leukemia with t(8;21) * usually with co-expression of CD19 by myeloblasts * APL (rare cases) * AML (rare cases) Also, cutaneous gamma-delta T cell lymphoma and BPDCN
52
In what neoplasms is CD56 been associated with a poor risk factor ?
* AML with t(8;21) and t(15;17) * in t(8;21) associated with significantly shorter complete remission duration and survival
53
What non-hematopoietic neoplasms can express CD56?
- Small cell carcinoma - Carcinoma with NE differentiation - Malignant melanoma - Neuroblastoma - Wilms Tumor - Rhabdomyosarcoma
54
What benign cells express CD19?
- Hematogones - B- cells - Plasma cells (variable, often dim or partial expression)
55
What neoplastic B cell lymphoproliferations express CD19?
- Majority of mature B cell LPDs - PCM, rare cases
56
What neoplastic B cell lymphoproliferations are often negative for CD19?
- PEL - ALK + Large B cell lymphoma - Plasmablast lymphoma - Subset of PTLD
57
What other tumors are positive for CD19?
- B-ALL/LBL - AML, subset (AML with t(8;21)(RUNX1-RUNX1T1) - MPAL; AML/B-ALL - CML in lymphoid blast crisis - Nodular lymphocyte predominant Hodgkin lymphoma
58
What type of molecule is CD19?
- integral membrane protein - expression is limited to B cells and follicular dendritic cells
59
What is the possible function of CD20?
- poorly understood - been implicated in B cell activation, regulation of B cell growth and regulation of transmembrane calcium flux
60
What cells is CD20 typically expressed on normally?
- B cells - Germinal center cells show brighter expression than mantle zone cells
61
What B cell lymphoproliferative disorders often show CD20 expression?
- CLL, dim expression - HCL and HCL-v - Majority of B cell lymphomas - PCM, minor subset
62
What T cell lymphoproliferations have been known to show CD20 expression?
- Aberrant expression has been documented in many cases - Usually seen only in a subset of the neoplastic cells - PTCL, NOS - ALCL, T-PLL, follicular T cell lymphoma, and AITL
63
What other neoplastic conditions have shown aberrant CD20 expression?
- B-ALL/LBL (rare cases, usually dim and or partial expression) - NLPHL - Hodgkin Lymphoma, minor subset - Thymoma, Type A (spindle, medullary subset)
64
What B cell lymphomas are notably negative for CD20?
- PBL - PEL - DLBCL associated with chronic inflammation - ALK positive large B cell lymphoma - DLBCL, rare cases
65
What is CD22 positive in ?
- CD22 is a B cell specific marker - Plasma cells are CD22 negative
66
What cells is CD22 positive in ?
- B-cells - Basophils, subset
67
What B cell lymphoproliferatie disorders is CD22 positive in ?
-Majority of mature B cell LPDs (somewhat dim) **IMP: CLL is negative -PCM, very rare cases - CD22 is bright in HCL and splenic MZL -Clonal plasma cell components of LPL may be CD22+
68
What acute leukemia's can express CD22 ?
- B-ALL/LBL - cytoplasmic expression of CD22 - MPAL; AML and B-ALL - Acute basophilic leukemia, subset
69
What other tumors can express CD22 ?
- Basophils in CML and AMLs with basophilic differentiation, they may also show CD13 and CD25 expression - Mast cell neoplasms
70
What neoplasms are notably negative for CD22 ?
- CLL - Plasma cell neoplasms * BUT clonal plasma cell components of LPL may be CD22+
71
What cells is CD23 normally positive in?
- benign B cells of the blood, mantle zone and germinal centers of lymph node and tonsil - subset of plasma cells - follicular dendritic cells - subset of activated T cells - subset of activated monocytes
72
What B cell lymphoproliferations are positive for CD23 ?
- CLL, strong expression - Follicular lymphoma, minor subset but particularly seen in the diffuse variant - MZL, very rare cases - B-PLL, rare cases - LPL, rare cases - HCL, rare cases - DLBCL, rare cases - PMBL, subset of cells - MCL, very rare cases - PCM, very rare cases
73
What acute leukemias may show CD23 expression ?
- Acute monoblastic leukemia, subset
74
What myeloid tumors may show CD23 expression ?
- CMML, minor subset
75
What other tumors may show CD23 expression?
- Follicular dendritic cell tumors
76
Can MCL express CD23?
- most are CD23 negative - subset of MCL may be dim for CD23
77
What B cell lymphoproliferations are negative for CD23 ?
- MCL - BL - HCL - majority of DLBCL - majority of nodal and splenic MZL
78
What other cells may express CD23 ?
- benign plasma cells - subset of plasma cells
79
What type of protein is CD24?
- it is a GPI linked protein also known as heat stable antigen (HSA)
80
What cells normally express CD24?
- surface of B cells (but not plasma cells) - granulocytes - follicular dendritic cells - epithelial cells
81
What diagnosis is CD24 typically used in a flow cytometry panel for?
- diagnosis of PNH
82
What lymphoproliferations can express CD24?
- B-ALL - majority of mature B cell LPDs * HCL, MZL * subset of DLBCL are usually negative or show dim expression
83
What type of protein is CD25 ?
-interleukin 2 receptor
84
What neoplasms are negative for CD25?
- AITL - HSTL - T-PLL - T-LGLL - HCL-v
85
The presence of CD25 expression by an AML is generally associated with what molecular findings?
- FLT3-ITD - DNMT3A - NPM1
86
What benign cells often express CD25 ?
- T-cells, subset - NK cells - B-cells, minor subset (dim expression) - Basophils
87
What B cell lymphoproliferations express CD25?
- HCL (not HCL-v) - CLL, rare cases - B-ALL, subset - Follicular lymphoma, rare cases - Splenic marginal zone lymphoma, subset -B- cell lymphoma subsets (MCLs and splenic red pulp B cell lymphoma are CD25 (-))
88
What T cell lymphoproliferations are positive for CD25?
- ATLL, strong expression (100% of cases) - ALCL, subset - MF, subset - PTCL, subset - Follicular T cell lymphoma, subset - ENKTL, majority of cases
89
Which acute leukemias can express CD25 ?
- AML, minor subset - B-ALL, subset - T-ALL, rare cases
90
What myeloid tumors can express CD25?
- Chronic eosinophilic leukemia, subset - CML in blast crisis, subset
91
What other tumors can express CD25?
- systemic mastocytosis (benign mast cells should be CD25-) - langerhans cell histiocytosis (LCH)
92
What type of protein is CD26?
- type II membrane protein, which is expressed on the membrane of mature thymocytes
93
What other normal cells can express CD26?
- T lymphocytes (upregulated upon activation) - B cells - NK cells - MacrophagesI
94
In what situations is the evaluation of CD26 particularly useful?
- patient's with MF - there is a loss of CD26 in ~92% of cases of transformed MF
95
In what neoplasms is CD26 negative?
- circulating neoplastic T cells from patient's with MF (Sezary Syndrome) - ATLL
96
What benign cells show expression of CD27?
- T-cells, subset - NK cells - B-cells (memory) - Thymocytes - Plasma cells
97
What B cell lymphoproliferations express CD27?
- CLL - B-APLL - FL - LPL - SMZL - Nodal marginal zone lymphoma - DLBCL - BL - MGUS ( CD27 is positive only in rare PCMs)
98
What T cell lymphoproliferations express CD27?
- Sezary syndrome (SS), subset (MF is negative!) - PTCL, minor subset - Follicular T cell lymphoma, subset - AITL, subset
99
What benign cells express CD30?
- activated B and T cells with immunoblast morphology - Atypical cells (immunoblasts) in EBV lymphadenitis or Kikuchi lymphadenopathy
100
What B cell lymphoproliferations can express CD30 ?
- DLBCL, subset - PEL - most cases - FL, rare cases - Primary mediastinal large B cell lymphoma (PMBL) - Lymphomatoid granulomatosis (LyG) - PCM, rare cases
101
What neoplasms generally have 100% expression of CD30?
-CHL - ALCL - PEL - Pagetoid reticulosis (variant of MF) - MF with large cell transformation
102
CD30 expression can help classify T cell lymphomas. What T cell lymphomas in general have strong and uniform expression of CD30?
- ALCL (ALK + and - ) - ATLL (large cells, subset of cells in acute form of ATLL) - Primary cutaneous ALCL - Breast-implant associated ALCL - MF with large cell transformation - rare cases of PTCL, NOS - ENKTL
103
What T cell lymphomas have focal, variable and weak expression of CD30?
- AITL - subset of PTCL, EATL, ENKTL, and MEITL
104
What other tumors can express CD30?
- subset of AML *often associated with FLT3-ITD, high leukocytosis and high risk disease - CHL - Aggressive systemic mastocytosis (benign mast cells are CD30 negative)
105
Approximately what percentage of DLBCL express CD30?
- 14-21% express CD30 - often associated with a unique gene expression profile - generally non-GC subtype - have a favorable prognosis
106
What is the recommendation for reporting of CD30 ?
- intensity of staining(1-3+) - percentage of tumor cells with membranous or Golgi staining (>1% or <1%) - this is due to the availability of anti-CD30 medications
107
What normal cells are positive for CD34?
- it is a marker of immaturity (myeloid and lymphoid) - hematogones - myeloblasts - immature megakaryocytes - mast cell progenitors
108
What types of AML's are typically negative for CD34?
- classic hyper granular APL - monocytic leukemias - AML's with NPM1 mutation Note: hypo granular APL is often CD34 positive
109
What other leukemias are CD34 positive ?
- B-ALL - T-ALL - MPAL Note: BPDCN's are negative for CD34
110
What other marker is positive in leukemias that are NPM1 negative but FLT3-ITD positive?
- CD34+ - also TdT+
111
What is the normal number and distribution of CD34+ blasts in the bone marrow?
- normal bone marrow has < 2% blasts - they are typically scattered individually without forming significant clusters
112
In myeloid neoplasms, what abnormal marker expression of CD34+ blasts can be helpful in diagnosing an abnormality by flow cytometry?
- CD117 (-) - CD123 + - down regulation of CD13, CD33, or CD45 - aberrant expression of CD7 or CD56
113
What markers may be helpful in fibrotic marrows to differentiate myeloblasts, hematogones, mast cells, immature basophils, immature erythroid cells and plasma cells?
- CD34, CD117, Pax5, MUM1, CD71, and tryptase - Myeloblasts: CD34 +, CD117 + - Hematogones: CD34+, Pax5+ - Mast cells: CD117+, Tryptase + - Immature basophils: Tryptase +, CD34 (-), CD117 (-) - Immature erythroid precursors: CD117+, CD71+, CD34(-) - Plasma cells: CD117+, MUM1+
114
What are some non-hematopoietic tumors that are CD34 positive?
- vascular tumors - Kaposi's sarcoma - DFSP - GIST - other soft tissue tumors
115
What type of marker is CD36?
- glycoprotein IV - monocytic marker similar to CD14 - expressed in mature monocytes
116
What disease processes can CD36 be positive in?
- BPDCN - Monocytic leukemias Note: in acute monoblastic leukemia, CD36 is more often positive than CD14 - only a minor subset of AMLs with/or without maturation may show aberrant CD36 expression
117
What is the expression of CD36 in APL and Acute megakaryoblastic leukemia ?
- APL: negative - Megakaryoblastic: usually positive and seen in cases associated with Trisomy 21
118
What benign cells express CD38?
- plasma cells - activated (stimulated ) B and T cells - Thymocytes - Hematogones - Neutrophils and maturing myeloid precursors - Eosinophils - Basophils - NK cells - classic monocytes (CD14 bright/ CD16 -)
119
What normal cells show bright/strong CD38 expression?
- high in B cell precursors and terminally differentiated plasma cells Note: expression is low to absent in mature B cells
120
What is the typical expression of CD38 in AML's?
- often positive (dim to moderate)
121
What mature neoplasms have bright CD38 expression?
- T cell neoplasms, esp ALCL or PTCL - High grade B cell lymphomas *Double hit, NOS, etc -Burkitt Lymphoma - subset of Hairy cell leukemia Note: generally MYC translocated B cell lymphomas have bright CD38
122
Why is CD38 evaluated in CLL and what is it's significance?
- based on the number of clonal cells expressing CD38 CLL can be divided into two categories - CLL >30% positive CD38 - CLL <30% positive CD38 - >30% CD38 positive = unmutated IGHV - <30% CD38 positive = mutated IGHV
123
The level of expression of CD38 in CLL correlates with clinical stage, response to treatment and overall survival. What does higher CD38 expression typically indicate/morphologically show?
- >30% = unmutated IGHV - more advanced stage - diffuse bone marrow involvement - atypical morphology - deletion 11q - trisomy 12 - poorer chemosensitivity - significantly shorter overall survival
124
What is important to remember about CD38 expression in patient's with CLL?
- in ~30% of patients the levels of CD38 expression and IGHV mutational status are discordant.
125
What is important to remember regarding CD38 treatment in plasma cell myeloma?
- anti-CD38 (Daratumumab) may cause a loss of CD38 expression plasma cells - other markers should be used to evaluate neoplastic plasma cells
126
What B cell lymphoproliferations express CD38?
- PCM, bright expression - CLL, subset - MCL, major subset - DLBCL, subset - FL, subset - HCL, minor subset - PEL - DLBCL, associated with chronic inflammation - PBL - ALK+ Large B cell lymphoma - BL - LPL - HGBCL - MZL, subset
127
What T cell lymphoproliferations are positive for CD38?
- ALCL, subset [ALK+ is ofte negative] - PTCL - ATLL, acute variant [chronic variant is negative] - T-PLL, subset -HTSL, subset -T-LGLL, majority - AITL, majority - ENKTL, majority
128
What acute leukemias can express CD38?
- AML, majority - B-ALL, majority - T-ALL, all cases
129
What other myeloid tumors may express CD38?
- Blasts and myeloid cells in MDS, MPN and mixed MDS/MPN
130
What other tumors can express CD38?
- BPDCN, subset
131
In what setting is the expression of CD43 useful?
- CD43 is NOT a lineage specific marker - it is present on a wide range of both benign and neoplastic hematopoietic cells - BUT it can be useful in cases of poorly differentiated or anaplastic neoplasms in demonstrating whether they are hematopoietic or non-hematopoietic in origin *rarely expressed by non-heme tumors
132
Most benign B cells are NEGATIVE for CD43 except in what location in the body?
- Benign B cells in the terminal ileum may show expression of CD43
133
In what subset of ALCL can CD43 be helpful?
- ALCL (null cell type) - CD43 may be the only expressed marker aside from CD30 and ALK
134
What benign cells may express CD43?
- T cells - NK cells - Neutrophils - Eosinophils - Basophils - Mast cells - Monocytes - Hematogones - Erythroblasts/Pronormoblasts - B cells, minor subset (<10%)
135
What B cell lymphoproliferations are POSITIVE for CD43?
- BL - MCL - CLL - MZL, subset - DLBCL, minor subset - Primary cutaneous DLBCL, leg type - ALK+ large B cell lymphoma, rare cases - PCM - LPL, rare cases - HCL, subset BUT HCL-v is CD43 negative
136
What T/NK cell lymphoproliferations are positive for CD43?
- Mature (peripheral) T-cell and NK-cell lymphomas
137
What acute leukemias may be positive for CD43?
- AML - B-ALL - T-ALL
138
What myeloid tumors may be positive for CD43?
- Blasts and myeloid cells in MDS, MPN and mixed MDS/MPN
139
What other hematopoietic tumors may be positive for CD43?
- BPDCN, subset - Langerhans cell sarcoma
140
CD45 is known as the leukocyte common antigen and is expressed on the majority of hematopoietic cells with the exception of which two?
- maturing megakaryocytes - erythroid cells
141
Which cells have the lowest expression of CD45?
- lower on blasts and immature forms
142
Which cells have the highest expression of CD45?
- maturę myelomonocytic cells and lymphocytes
143
What neoplasms are notably NEGATIVE for CD45?
- PCM - Classic HL (R-S and H-S cells) - Acute erythroid leukemia - B-ALL/LBL, subset - PBL - Rare cases of ALCL and other mature T cell neoplasms - AML, rare cases - DLBCL, rare cases - T-PLL, subset - Dendritic cell sarcoma
144
What normal cells express CD49d?
- B and T cells - thymocytes - langerhan cells - eosinophils - monocytes
145
In what neoplasm is CD49d emerging as a prognostic marker?
- one of the most valuable markers in CLL/SLL for prognostics - Considered positive if >30% of cells express it - ~40-60% of CLL cases express this marker - Detection of CD49d is superior to CD38 and ZAP-70 in predicting overall and treatment-free survival
146
What are high levels of expression of CD49d associated with in CLL?
- shorter time from diagnosis to treatment and overall survival - prognostic value of CD49d is independent of other prognostic parameters including FISH and IGVH, positive CD38, and ZAP70 expression
147
In what setting would you see lower expression of CD49d in CLL?
- patients with a deletion of 11q
148
In what setting would you see higher expression of CD49d in CLL?
- patients with trisomy 12
149
What is the medication name for Alemtuzumab and what antibody does it target?
- Campath - targets CD52
150
What is the mechanism of action of Campath?
- antibody-dependent cell mediated cellular toxicity leading to complement activation and apoptosis
151
What cells express CD52?
- normal and malignant T cells - majority of B lymphoproliferations
152
In what setting has Campath been used for treatment?
- CLL - T-PLL - low-grade Non- Hodgkin Lymphomas
153
What normal cells typically express CD65?
- Neutrophils - Eosinophils - Basophils - Monocytes, subset - NK cells, minor subset
154
What acute leukemias are known to express CD65?
- AML, subset - Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL), subset
155
What type of marker is CD79?
- it is a B cell marker which can be detected on the B cell surface or intracytoplasmic
156
What benign cells express CD79?
- B cells - Hematogones
157
What B cell proliferations are positive for CD79?
- Majority of mature B cell lymphoproliferative disorders (CLL, PEL, and PBL) *for both CD79a and CD79b
158
B-ALL typically expresses which isoform of CD79?
- CD79a - CD79b is variably expressed with a subset of cases being negative
159
What is the difference in CD79 expression in CLL and MCL?
- CLL: CD79b negative - MCL: CD79b positive
160
What benign cells express CD81 ?
- Hematogones (bright expression) - Plasma cells - Myeloblasts - B-cells - T-cells - NK cells - Mast cells - Dendritic cells
161
What role does CD81 play ?
- CD81 is critical for B cell development and the humoral response - interacts with CD19 in B cell development
162
How is CD81 helpful in the evaluation of B-ALL?
- CD81 is usually dimly expressed in B-ALL, which helps with the differential diagnosis with hematogones (brightly positive for CD81)
163
How is CD81 helpful in the evaluation of plasma cell myeloma?
- benign plasma cells show bright expression of CD81 - most malignant plasma cells show either dim or negative CD81 IMP: expression of CD81 by PCM is a poor prognostic indicator
164
What is CD81 expression in BL?
- BL shows bright positive expression of CD81
165
What is CD81 expression in FL and DLBCL?
- dimmer expression of CD81 as compared to BL
166
What is the expression of CD81 in CLL and MCL?
- CLL is negative to partially dim - MCL is positive
167
What is the expression of CD81 in HCL and HCL-v?
- Both HCL and HCL-v are CD81 positive - BUT *HCL-v has brighter CD81 expression
168
What is unique about CD133?
- it is a primitive cell antigen that has been shown to be a more specific marker of hematopoietic stem cells as compared to CD34
169
What benign cells express CD133?
- Myeloblasts
170
What malignancies express CD133?
- AML, subset - Blasts in MDS and CMML may be CD133+
171
In AML the expression of CD133 has been also shown to be correlated with the expression of what other markers?
- HLA-DR - CD3 - CD7 - TDT - CD13 - CD34
172
What is the expression of CD138 in plasma cell neoplasms compared to normal plasma cells?
- the expression of CD138 in plasma cell neoplasms is often dimmer than in benign plasma cells when analyzed by FC
173
What B cell lymphoproliferations can express CD138?
- PCM - ALK+ large B cell lymphoma - PBL - DLBCL, subset - PEL
174
What is CD157 a marker of and what disease process can it be seen in?
- GPI-linked protein expressed on neutrophils and monocytes - used in panels to evaluate for PNH
175
Flow Cytometry
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