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Background: Differential diagnosis of CLDs has remained challenging due to the highly variable morphology features and immunophenotyping. Currently, the development of multiple-marker panel analyses by flow cytometry has opened a broad way to diagnosis of CLDs. Methods: We analyzed the peripheral blood and BM samples of 131 patients with B-cell CLDs (including 91 CLL, 15 atypical CLL, 14 MCL, and 11 CD5-/CD10-lymphoma patients) from April 2018 to April 2019 using a panel of specific markers by flow cytometry. Results: Our results indicated that the expression pattern of CD22, CD23, FMC-7, and CD5 allowed for accurate differential diagnosis of B-CLL, MCL, and CD5-/CD10- lymphoma, while it was not capable of differentiating MCL and atypical CLL. We, however, found that the expression patterns of CD38 and immunoglobulin light chain differed significantly in these two entities. CD38 and lambda light chain were remarkably expressed in MCL patients (92.8% and 85%, respectively) compared to atypical CLL (1.1% and 0% respectively), with the p < 0.001 for both markers. In contrast to MCL patients, all the patients with atypical CLL expressed kappa light chain. The IHC method for cyclin D1 confirmed that the flow cytometry detection of kappa and lambda light chains could provide a new approach with high sensitivity (91%) and moderate specificity (50%) for distinguishing MCL patients from atypical B-CLL. Conclusion: Expression of CD5, CD20 (bright), CD22, FMC-7, CD38, and lambda light chain with no expression of CD23 can accurately detect MCL and differentiate it from atypical B-CLL.
Type of Study: Full Length | Subject: Related Fields

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