Nodal Low-Grade B-Cell Lymphoma Co-Expressing CD5 and CD10 but Not CD23, IRTA1, or Cyclin D1: The Diagnostic Challenge of a Splenic Marginal Zone Lymphoma

The diagnosis of lymphoma is based on histopathological and immunophenotypical features. CD5 and CD10 are traditionally considered a T-cell antigen and a germinal center B-cell antigen, respectively. It is very unusual for a low-grade B-cell lymphoma (BCL) to co-express CD5 and CD10. Although the bi...

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Bibliographic Details
Published in:Diagnostics (Basel) 2024-03, Vol.14 (6), p.640
Main Authors: Win, Khin-Than, Hsieh, Yen-Chuan, Wu, Hung-Chang, Chuang, Shih-Sung
Format: Article
Language:English
Subjects:
Abdomen
Antigens
B cells
Bendamustine
Bone marrow
CD10
CD5
Flow cytometry
Genotype & phenotype
Histopathology
Immunoglobulin E
Interesting Images
Leukemia
Lymphatic system
Lymphocytes
Lymphoma
marginal zone lymphoma
Medical imaging
Non-Hodgkin's lymphomas
phenotypic aberrancy
splenic marginal zone lymphoma
T cells
villous lymphocyte
Vincristine
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Summary:The diagnosis of lymphoma is based on histopathological and immunophenotypical features. CD5 and CD10 are traditionally considered a T-cell antigen and a germinal center B-cell antigen, respectively. It is very unusual for a low-grade B-cell lymphoma (BCL) to co-express CD5 and CD10. Although the biologic basis or clinical significance of such co-expression is unclear, this rare event may pose a significant diagnostic challenge. Here, we report a case of a 63-year-old male presenting with bilateral cervical lymphadenopathy and lymphocytosis. Histologically, the nodal tumor was largely diffuse with neoplastic small atypical lymphocytes co-expressing CD5, CD10, and CD20, but not CD23 or cyclin D1. The leukemic cells in the peripheral blood exhibited hairy projections. Taking together the marked splenomegaly, involvement of lymph nodes, bone marrow, and peripheral blood, a final diagnosis of splenic marginal zone lymphoma (SMZL) was reached. The patient was alive with partial response for 10 months after immunochemotherapy. The dual expression of CD5 and CD10 is extremely unusual for low-grade BCL and may lead to an erroneous diagnosis. Integrating the findings into peripheral blood smear tests, flow cytometry, histopathology, imaging, and clinical features is mandatory to exclude other lymphoma types and to reach a correct diagnosis, particularly for a case with nodal presentation.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics14060640