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Compendium Hematopathology > Immunophenotyping > Flashcards

Immunophenotyping Flashcards

1
Q

Alk

A
  • expressed in t(2;5) anaplastic large cell lymphoma
  • can be positive in IMT from multiple sites
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2
Q

bcl-1 (cyclin D1, PRADA-1)

A
  • expressed in mantle cell lymphoma (nuclear staining)
  • hairy cell leukemia and plasma cell neoplasm may also be positive
  • breast and colon carcinoma are positive
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3
Q

bcl-2

A
  • Reactive lymph nodes expressed by
    • T cells
    • mantle B cells
    • small number of mantle B cells that normally permeate the follicle center (increased in follicular lysis)
  • Also positive in
    • most low grade B cell lymphomas and many high grade B cell lymphomas
    • expression in follicular lymphoma decreases with grade
      • >95% in grade 1 and 75% in grade 3
  • not expressed in Burkitt lymphoma; helpful to separate Burkitt from Burkittlike lymphoma
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4
Q

bcl-6

A
  • strongly expressed in normal germinal center B cells
  • expressed in some lymphomas, including
    1. Burkitt lymphoma
    2. follicular lymphoma
    3. nodular lymphocyte predominant HL
    4. angioimmunoblastic T cell lymphoma
    5. subset of DLBCL
    6. ? anaplastic large cell lymphoma ?
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5
Q

CD1a

A
  • expressed by
    • Langerhans cells
    • dendritic reticulum cells
    • interdigitating reticulum cells
    • cortical thymocytes
  • Langerhans cell histiocytosis shows coexpression of S100 and CD1a
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6
Q

CD2

A

expressed by T and NK cells from a very early stage

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7
Q

CD3

A
  • expressed by T cells (mature and nonneoplastic)
  • noncovalent association with TCR
  • composed of 3 chains: gamma, delta, and epsilon
  • cytoplasmic expression may be present in immature T cells and NK cells, which lack surface CD3
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8
Q

CD4

A
  • expressed by
    • subset of T helper cells
    • monocytes
    • histiocytes
    • dendritic cells
  • normal CD4:CD8 in blood is 2-4:1
  • CD4+/CD8+ T cells are normal only in thymus; otherwise probably neoplastic
  • CD4-/CD8- T cells only normal in early T cell maturation
  • most T cell neoplasms are CD4+
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9
Q

CD5

A
  • expressed by
    • normal T cells
    • small number of B cells
  • not expressed by NK cells
  • CD5 coexpression in B cells is hallmark of SLL/CLL and MCL
  • sometimes lost in T cell neoplasms
  • expressed in most thymic carcinomas
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10
Q

CD7

A
  • expressed by both T cells and NK cells
  • CD7 loss is often seen in T cell neoplasms, especially cutaneous T cell lymphoma
  • sometimes expressed in myeloblasts (M4 and M5 types)
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11
Q

CD8

A
  • expressed by CD4- T cells
  • often expressed in neoplastic NK, T cytotoxic and T suppressor cells
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12
Q

CD10 (CALLA)

A
  • expressed by
    1. normal and neoplastic follicle center cells
    2. normal granulocytes
    3. follicular lymphoma (less so with higher grade)
    4. NLPHL
    5. angioimmunoblastic T cell lymphoma
    6. most B cell ALL
    7. often in plasma cell neoplasms
    8. nonhematolymphoid tumors
      • RCC
      • endometrial stromal sarcoma
      • HCC (canalicular pattern)
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13
Q

CD11b (MAC-1)

A
  1. normally expressed by monocytes and granulocytes
  2. positive in hairy cell leukemia
  3. AML with inv(16) or t(16;16)
  4. AML with t(9;11)
  5. Acute myelomonocytic leukemia
  6. Acute monocytic/monoblastic leukemia
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14
Q

CD11c (C3r)

A
  • normally expressed by monocytes and granulocytes
  • strongly positive in hairy cell leukemia
  • expressed weakly in CLL
  • negative in MCL
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15
Q

CD13

A
  • expressed by granulocytes and precursors
  • expressed in nearly all types of AML
  • may be weakly expressed in ALL
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16
Q

CD14

A
  • expressed by monocytes
  • variably expressed in AML with monocytic/monoblastic differentiation
    • AML with t(9;11)
    • AML with inv(16)
    • Acute myelomonocytic leukemia
    • Acute monocytic/monoblastic leukemia
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17
Q

CD15 (Leu-M1)

A
  • expressed in
    • mature monocytes and granulocytes
    • RS cells
    • most adenocarcinomas
  • negative in ALCL
  • in AML, CD15 indicates a maturing phenotype
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18
Q

CD16

A

expressed by normal and neoplastic NK cells and granulocytes

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19
Q

CD19

A
  • expressed by
    • B cells from pro/pre B stage onward
    • normal plasma cells, but lost in neoplasm
    • dim in follicular lymphoma
    • some myeloblasts, especially AML with t(8;21)
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20
Q

CD20

A
  • expressed on surface of mature B cells
  • not expressed by plasma cells
  • usually not expressed in classic HL (positive in 20%)
  • NLPHL is uniformly positive
  • dim in CLL
  • FMC-7 is an antibody that recognizes a particular epitope of CD20
    • cells with weak CD20 (CLL) tend to be FMC-7 negative
    • cells with bright CD20 tend to be FMC-7 positive (e.g., most other B-NHLs)
21
Q

CD23

A

the IgE receptor

  • positive in CLL
  • negative in MCL
  • often positive in FL
22
Q

CD25

A

IL-2 receptor

  • expressed by
    • activated lymphoid cells (T&B)
    • hairy cell leukemia
    • adult T cell leukemia (ATCL)
      • soluble IL-2 receptor is usually elevated also
    • expression in mast cells indicates KIT rearrangement and clonality
23
Q

CD30

A
  • Ki-1; Ber-H2
  • expressed by
    1. normal plasma cells
    2. immunoblasts
    3. NK cells
    4. RS cells
    5. ALCL
    6. embryonal carcinoma
    7. mediastinal B cell lymphoma
24
Q

CD33

A

expressed by normal and neoplastic myelomonocytic cells

25
Q

CD34

A
  • expressed by
    • normal and neoplastic endothelial cells
    • immature hematolymphoid cells
    • GIST
    • DFSP
    • SFT
26
Q

CD38

A
  • expressed by
    • activated T and B cells
    • plasma cells
    • B, T, and plasma cell neoplasms
    • expression in CLL is (like ZAP-70) indicative of IgVH nonmutated status and a more aggresive clinical course
27
Q

CD41 and CD61

A
  • expressed by normal and neoplastic megs
28
Q

CD43

A
  • expressed by normal and neoplastic T cells
  • underexpressed in WAS
  • anomalously expressed on B cells in MCL, SLL, and some MZL (especially MALT)
  • not expressed in FL
29
Q

CD45 (LCA)

A
  • present in nearly all normal and neoplastic leukocytes
  • as they differentiate CD45 expression by hematolymphoid cells changes, with
    • mature lymphs and monocytes having bright expression
    • granulocytes intermediate expression
    • erythrocytes almost negative
  • blasts are dim to negative CD45
  • plasma cells are dim to negative CD45
  • Not expressed by RS cells
30
Q

CD45-RO (UCHL-1)

A
  • expressed by normal and neoplastic T cells
31
Q

CD56

A
  • expressed by
    1. normal and neoplastic NK cells
    2. neuroepithelial cells (small cell CA)
    3. plasma cell neoplasms
    4. can be positive in AML with t(8;21)
  • absent in plasmablastic lymphoma
32
Q

CD57 (Leu-7)

A

expresed by a subset of normal and neoplastic NK cells and neuroepithelial cells

33
Q

CD59

A
  • present on nearly all human cells
  • decreased (along with CD55/DAF) in PNH
34
Q

CD68

A
  • expressed by macrophages and histiocytes, but its specificity is poor
35
Q

CD71

A
  • aka, transferrin receptor
  • expressed in
    • highly metabolic cells
    • higher levels correlate with tumor grade in hematolymphoid neoplasms
36
Q

CD79a

A
  • expressed by normal and neoplastic B cells and plasma cells
  • negative in RS cells
37
Q

CD99 (p30/32, mic-2; O-13)

A
  • expressed in
    1. ALL
    2. PNET/Ewing
    3. granulosa cell tumors
    4. synovial sarcoma
    5. RMS
    6. SFT
38
Q

CD103

A

sensitive and specific marker for hairy cell leukemia

39
Q

CD117 (c-kit)

A
  • expressed by
    1. interstitial cell of Cajal (the precursors of GIST)
    2. melanocytes
    3. seminoma
    4. progenitor myeloid cells (AML, CML)
    5. mast cells
40
Q

CD138

A
  • plasma cell marker
  • specific among hematolymphoid neoplasms for plasma cells, but is positive in a wide range of epithelial and mesenchymal tumors
41
Q

Clusterin

A
  • expression in a discrete Golgi pattern in ALCL
  • strong cytoplasmic reactivity in megs
42
Q

EMA

A
  • expressed by
    1. plasma cells
    2. ALCL
    3. NLPHL
    4. PEL
    5. T cell rich B cell lymphoma
43
Q

fascin

A
  • expressed by RS cells and dendritic reticulum cell
44
Q

HLA-DR

A
  • expressed by
    • monocytes
    • B cells
    • activated T cells
  • positive in B-ALL/LBL and most myeloblasts
  • negative in T-ALL and APML
45
Q

PAX5

A
  • nuclear expression in B cell neoplasms and classic HL
  • negative in T cell neoplasms and plasma cell neoplasms
  • may be positive in Merkel cell carcinoma and small carcinoma of the lung
46
Q

S100

A
  • expressed in nuclear and cytoplasmic compartments
  • expressed by
    • neural and neural crest tissues
      • glial cells
      • Schwann cells
      • melanocytes
      • sustentacular cells of adrenal medulla
      • chondrocytes
      • adipocytes
      • myoepithelial cells
    • subset of histiocytes
      • interdigitating reticulum cells
      • dendritic reticulum cells
      • Langerhans cells
47
Q

ZAP-70

A
  • normally expressed primarily by T and NK cells
  • expressed in subset of CLL, B-ALL, and most T cell neoplasms
  • expression in CLL correlated with unmutated IgVH status and a more aggressive course
48
Q

CD34 and HLA-DR are negative in

A
  1. AML with t(15;17)
  2. AML with t(1;22)
  3. +/- in acute megakaryoblastic leukemia

Compendium Hematopathology (8 decks)

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