Benign hematogone-rich lymphoid proliferations can be distinguished from B-lineage acute lymphoblastic leukemia by integration of morphology, immunophenotype, adhesion molecule expression, and architectural features

Lisa M Rimsza, Richard S. Larson, Stuart S. Winter, Kathy Foucar, Yap Yee Chong, Kelly W. Garner, Catherine P. Leith

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Distinction of normal B-lymphoid proliferations including precursors known as hematogones from acute lymphoblastic leukemia (ALL) is critical for disease management. We present a multiparameter assessment of 27 bone marrow samples containing at least 25% hematogones (range, 25%-72%) by morphologic review. We used flow cytometry to evaluate B-cell differentiation antigen and adhesion molecule expression and immunohistochemistry on clot sections to evaluate architectural distribution. Flow cytometry revealed that intermediately differentiated cells (CD19+, CD10+) predominated, followed in frequency by CD20+, surface immunoglobulin-positive cells, with CD34+, terminal deoxynucleotidyl transferase (TdT)-positive cells as the smallest subset. Adhesion molecules (CD44, CD54) were expressed more heterogeneously compared with expression in acute lymphoblastic leukemia. Immunohistochemistry revealed that CD34+, TdT-positive cells were dispersed without significant clustering, while CD20+ cells exceeded CD34/TdT-positive cells in 24 of 25 cases. This multidisciplinary study demonstrates that hematogone-rich lymphoid proliferations exhibit a spectrum of B-lymphoid differentiation antigen expression with predominance of intermediate and mature B-lineage cells, heterogeneity of adhesion molecule expression, and nonclustered bone marrow architectural distribution.

Original languageEnglish (US)
Pages (from-to)66-75
Number of pages10
JournalAmerican Journal of Clinical Pathology
Volume114
Issue number1
DOIs
StatePublished - 2000
Externally publishedYes

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
DNA Nucleotidylexotransferase
B-Lymphocyte Differentiation Antigens
Flow Cytometry
Bone Marrow
Immunohistochemistry
B-Cell Antigen Receptors
Differentiation Antigens
Cell Adhesion Molecules
Disease Management
Cell Adhesion
Cluster Analysis

Keywords

  • Adhesion molecules
  • Clot sections, Immunohistochemistry
  • Flow cytometry
  • Hematogones
  • Immunophenotype

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Benign hematogone-rich lymphoid proliferations can be distinguished from B-lineage acute lymphoblastic leukemia by integration of morphology, immunophenotype, adhesion molecule expression, and architectural features. / Rimsza, Lisa M; Larson, Richard S.; Winter, Stuart S.; Foucar, Kathy; Chong, Yap Yee; Garner, Kelly W.; Leith, Catherine P.

In: American Journal of Clinical Pathology, Vol. 114, No. 1, 2000, p. 66-75.

Research output: Contribution to journalArticle

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