CD5 positive follicular lymphomas: A diagnostic dilemma in a resource restricted laboratory setting
Keywords:
Follicular lymphoma, CD 5 positive, indolent lymphomas, B cell NHL, ImmunohistochemistryAbstract
Background: Follicular lymphoma is an indolent B Non Hodgkin lymphoma which has a characteristic follicular growth pattern and immunohistochemical expression. The neoplastic cells express CD20, CD10, BCL2 and are negative for CD5, CD23 and Cyclin D1. CD5 is a useful marker in the differentiation of various B cell lymphomas. Small cell lymphoma and mantle cell lymphoma express CD5. Some of the follicular lymphomas express CD5 which results in diagnostic confusion.
Methods: 52 cases of lymphoma were diagnosed over a period of 2 years in a tertiary care centre in south India. Among these, 9 cases were diagnosed as follicular lymphoma based on the morphological abd immunohistochemical study. A panel of antibodies were chosen based on the morphological diagnosis.The panel used for small cell lymphomas include CD20, CD3, CD5 CD23, Cyclin D1, CD10, BCL2 and Ki67.
Result: Of the nine cases of follicular lymphoma, three were CD5 positive. Two showed bone marrow involvement. There was no significant morphological difference between CD5 positive and CD5 negative follicular lymphoma.
Conclusion: The expression of CD5 by follicular lymphomas could be problematic when the follicular lymphoma as such lacks its characteristic follicular pattern and there are no molecular studies available. Eventhough rare , follicular lymphoma is to be considered in the differential diagnosis of CD5 positive follicular lymphomas.
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DOI:Â 10.21276/APALM.1364
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Copyright (c) 2017 Sakthi Sankari Shanmuga, Arjunan Angaraju, Bhuvaneswari M Ganesan, Sindhuja Ramalingam, Rajeswari Thivya Dhanabalan
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