Immunophenotyping

Question 1

CLL score

Answer 1

Surface Ig weak
CD5 positive
CD23 positive
FMC7 negative
CD22 or CD79a weak

Most score 4 or 5
CD200 also usually positive

Question 2

Follicular lymphoma

Answer 2

CD5 negative
CD10 positive
Bcl-2 postive
CD19 dim
CD20/22 positive
CD38 positive

Question 3

Mantle cell lymphoma

Answer 3

CD5 positive
CD10 negative
CD20 moderate
CD23 negative
Ig positive
CD200 negative

Question 4

Burkitt lymphoma

Answer 4

CD5 negative
CD10 positive
CD19/20/22/79a positive
CD23 negative
Surface LC positive (restricted)
Ki67 bright
TdT negative

Question 5

DLBCL

Answer 5

CD5 negative
CD10 positive
CD19/20/22/79a positive
CD23 negative

Question 6

Hairy cell leukaemia

Answer 6

CD5 negative
CD10 negative
CD20/22 bright
CD25 bright
CD11c bright
CD103 positive
CD123 positive

Question 7

Marginal zone lymphoma

Answer 7

CD5 negative
CD10 negative
CD20 positive

Question 8

AML Erythroblastic (M6)

Answer 8

Positive
Glycophorin A (CD235a)
CD71
CD36
Possibly EpCAM weak

Negative
MPO
CD34
CD45

Morphology: 80% BM erythroid with 30% erythroblasts
Commonly complex karyotype

Question 9

AML Megakaryoblastic (M7)

Answer 9

Positive
CD41, CD61, CD64

Negative
CD13, HLA-DR

Question 10

AML Minimal Diff (M0)

Answer 10

Positive
Stem/myeloid markers (HLA-DR, CD34, CD38)
Sometime CD2/CD7, TdT

Negative
MPO
B/T markers

Question 11

Mastocytosis

Answer 11

CD45+
CD117+
CD30+
CD2+
CD25+

Question 12

AML myelomonocytic with inv16

Answer 12

Blasts CD34+ CD117+
Monocytic cells CD14+ CD64+
Aberrant CD2

Question 13

PNH diagnosis

Answer 13

Test
Hb-uria
DAT neg haemolysis or otherwise unexplained esp unusual site eg intra-abdo
MDS/AA

Start with WBC as false neg on red cells (short half life + transfusion)
Gate neuts as CD45dim/CD15pos - then %PNH as double neg FLAER/CD24
Gate monos as CD45+/CD64 pos - then %PNH double neg FLAER/CD14
If PNH then test RC clone size as %CD235a that is CD59 neg

RC type 1 = CD235a+/CD59+
RC type 2 = CD235a+/CD59dim
RC type 3 = CD235a+/CD59neg

Question 14

Glanzmann

Answer 14

Reduced expression CD41 and CD61

Question 15

AML Monocytic

Answer 15

CD11c pos
CD14
CD64 pos
HLA-DR pos

Question 16

MPAL

Answer 16

MPO or Monocytic marker
With
Strong cytCD3
Or
Strong CD19 with 79a, 22 or 10

Question 17

HCL-variant

Answer 17

Same as HCL but CD25 negative and CD123 negative

Question 18

ATLL

Answer 18

CD25 pos
CD4+
HTLV1+

Question 19

ALCL

Answer 19

CD30 pos
SSC high
FSC high

Question 20

T-PLL

Answer 20

CD2, CD3, CD5, CD7, CD52 positive
Usually CD4, 25% double positive

TCL1 rearrangement (chr14)

Question 21

Sezary

Answer 21

CD4+
CD3+ (mature T)

CD7neg

Question 22

T-LGL

Answer 22

CD3+
TCR αβ+
CD8+
CD16+
CD57+

CD45dim

CD4−
CD27−
CD28−