chronic lymphocytic leukemia small cell lymphoma lymph node hematopathology cd5 b cell lymphocyte proliferation center psuedofollicle

Picture Info
Diagnosis:	Chronic lymphocytic leukemia / Small cell lymphoma
Contributed By:	PathDoc15
Contributed On:	3/13/2008 5:46:33 AM
Additional Info:	This higher power view of a lymph node shows a proliferation center( psuedofollicle) of CLL. Proliferation centers are composed of medium sized to larger cells (prolymphocytes and paraimmunoblasts). This histologic appearance coupled with a characteristic (but not 100% specific or sensitive) surface antigen profile (CD5 positive, CD23 positive, Surface Ig weak). CLL lacks the t(11;14) an associated cyclin D1 overexpression seen in mantle cell lymphoma(the other CD5 lymphoma).
Tags:	chronic lymphocytic leukemia small cell lymphoma lymph node hematopathology cd5 b cell lymphocyte proliferation center psuedofollicle

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Great image. In CD23 negative cases, beware of the Small cell varriant of multiple myeloma. It also has the t(11:14) and stains positive (moderate, and varriable, like MCL) for cyclin D1. Unlike the translocation in MCL, this finding in myeloma is thought to portend a better prognosis. ----Comment by: Iago on 3/13/2008 9:54:33 AM
Excellent points. Are small cell myelomas CD5 positive, though? ----Comment by: PathDoc15 on 3/14/2008 7:15:51 AM
I dont think so however they must be CD38 and CD138 positive the lasted being more specific. Here is a good review article from England shrot and straight to the point :http://www.blackwell-synergy.com/doi/full/10.1111/j.1365-2559.2004.01763.x?cookieSet 1 ----Comment by: savco on 3/14/2008 8:37:06 AM
...and of course CD56 is a great marker for myeloma across the board (vs. normal plasma cell) ----Comment by: PathDoc15 on 3/14/2008 12:35:30 PM
Don't forget about the potential pitfall of CD20 staining in the small cell variant of myeloma. Not every case with t(11;14) stains with CD20, but there is a positive association between CD20-positivity and the presence of t(11;14). ----Comment by: DrJ on 3/14/2008 6:22:37 PM

Great image. In CD23 negative cases, beware of the Small cell varriant of multiple myeloma. It also has the t(11:14) and stains positive (moderate, and varriable, like MCL) for cyclin D1. Unlike the translocation in MCL, this finding in myeloma is thought to portend a better prognosis.

----Comment by: Iago on 3/13/2008 9:54:33 AM

Excellent points. Are small cell myelomas CD5 positive, though?

----Comment by: PathDoc15 on 3/14/2008 7:15:51 AM

I dont think so however they must be CD38 and CD138 positive the lasted being more specific. Here is a good review article from England shrot and straight to the point :http://www.blackwell-synergy.com/doi/full/10.1111/j.1365-2559.2004.01763.x?cookieSet 1

----Comment by: savco on 3/14/2008 8:37:06 AM

...and of course CD56 is a great marker for myeloma across the board (vs. normal plasma cell)

----Comment by: PathDoc15 on 3/14/2008 12:35:30 PM

Don't forget about the potential pitfall of CD20 staining in the small cell variant of myeloma. Not every case with t(11;14) stains with CD20, but there is a positive association between CD20-positivity and the presence of t(11;14).

----Comment by: DrJ on 3/14/2008 6:22:37 PM

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