CD5 positive follicular lymphomas: A diagnostic dilemma in a resource restricted laboratory setting

  • Sakthi Sankari Shanmuga Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamilnadu, India, 641004
  • Arjunan Angaraju Department of Pathology, Coimbatore Medical college, Coimbatore, Tamilnadu, India
  • Bhuvaneswari M Ganesan Department of Pathology, Coimbatore Medical college, Coimbatore, Tamilnadu, India
  • Sindhuja Ramalingam Department of Pathology, Thirunelveli Medical college, Tamilnadu, India
  • Rajeswari Thivya Dhanabalan Department of Pathology, Karpaga Vinayaga Medical College, Kanchipuram, Tamilnadu, India
Keywords: Follicular lymphoma, CD 5 positive, indolent lymphomas, B cell NHL, Immunohistochemistry

Abstract

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. DOI: 10.21276/APALM.1364

Author Biography

Sakthi Sankari Shanmuga, Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamilnadu, India, 641004
Pathology, Assistant Professor

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Published
2017-12-10
Issue
Vol 4 No 6 (2017)
Section
Original Article

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