CD10, HLA-DR, Kappa, and Lambda

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The page below is a sample from the LabCE course Introduction to Flow Cytometry: Blood Cell Identification. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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CD10, HLA-DR, Kappa, and Lambda

Continuing with this case, note that 0% of the cells are positive for CD10 and 10% are positive for HLA-DR. The percentages of cells positive for Kappa and Lambda are 4% and 3%, respectively. The results thus far are:

CD19= 7%
CD20= 7%
HLA-DR= 10%
CD10= 0%

Given this information, follicular lymphoma can be ruled out because CD10 is not present. Referring to the decision tree, (on the right) the CD10 surface marker would be positive with follicular lymphoma.
Kappa and Lambda light chains are expressed with the normal 2:1 ratio, which helps to rule out a B-cell neoplastic process. If the B lymphocytes expressed only one type of light chain (kappa or lambda), or one predominated significantly, a malignant, clonal population would be suspected.
It is important to also examine the T cell results to determine whether or not there is normal representation of the expected antigens.