Classification of small B-cell lymphoid neoplasms using a paraffin section immunohistochemical panel.
Immunophenotypic analysis is critical in categorizing small B-cell neoplasms; however, many recommended antibody panels have required fresh or frozen tissue. Many paraffin-reactive antibodies are now available but have been studied mostly in isolation. Therefore, the utility of a panel of paraffin-reactive antibodies in differentiating small B-cell neoplasms was investigated. Paraffin-embedded sections of small lymphocytic lymphoma/B-chronic lymphocytic leukemia (SLL/B-CLL; 12), mantle cell (MCL; 15), follicular (FL; 11), and marginal zone B-cell (MZL; eight) lymphomas were stained with CD20/L26, CD3, CD43/DF-T1 or Leu22, CD5/4C7, CD23/BU38, cyclin D1/H295, and CD10/56C6 antibodies. For select antibodies, results were compared to flow cytometric data (FC). Formalin and B5 fixation were also compared. Seven of 11 SLL/B-CLL were CD43+ CD5+ CD23+ cyclin D1- CD10-; seven of 11 MCL were CD43+ CD5+ CD23- cyclin D1+ CD10-; nine of 10 FL were CD43- CD5- CD23- cyclin D1- CD10+; and five of six MZL were CD43+ CD5- CD23- cyclin D1- CD10-. CD5, CD23, and CD10 stains showed sensitivities of 81, 88, and 100%, respectively, compared to FC. With B5 fixation, cyclin D1 was more often negative and CD5 more often equivocal. A panel of paraffin-reactive antibodies aids in classification of small B-cell neoplasms, although a small number of cases have indeterminate phenotypes and MZL have no defining features. CD5 separates most SLL/B-CLL and MCL from FL and MZL. CD23 separates SLL/B-CLL from most MCL, but cyclin D1 is most important for identifying MCL. CD10 positivity distinguishes most FL from other small B-cell lymphoid neoplasms.
Chen
C C
CC
Department of Pathology, University of Pittsburgh School of Medicine, Pennsylvania 15213-2582, USA.
Raikow
R B
RB
Sonmez-Alpan
E
E
Swerdlow
S H
SH
D015703:Antigens, CD / Q000378:metabolism; D019938:Cyclin D1 / Q000378:metabolism; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000145:classification* / Q000378:metabolism* / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000145:classification* / Q000378:metabolism* / Q000473:pathology; D008224:Lymphoma, Follicular / Q000145:classification / Q000378:metabolism / Q000473:pathology; D020522:Lymphoma, Mantle-Cell / Q000145:classification / Q000378:metabolism / Q000473:pathology; D016612:Paraffin Embedding
D015703:Antigens, CD; D019938:Cyclin D1