Journal
CYTOMETRY PART B-CLINICAL CYTOMETRY
Volume 104, Issue 3, Pages 263-270Publisher
WILEY
DOI: 10.1002/cyto.b.22107
Keywords
flow cytometry; immunoglobulin light chain; lymphoma; mature B cells
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This study investigates the mechanism and diagnostic significance of sIg negative mature B cells. It found that sIg negative reactive B cells were polytypic, while sIg negative mature B-cell lymphomas showed distinct patterns of abnormal light chain expression. Therefore, a diagnosis of B-cell lymphoma should not be based solely on the lack of sIg, and further evaluation of cIg expression is necessary.
BackgroundSurface immunoglobulin (sIg) light chains are not always detected on mature B cells. This may present as a challenge for clonality determination in clinical flow cytometry. MethodsTo explore the mechanism and diagnostic significance of sIg negative mature B cells, we retrospectively studied 14 cases of sIg negative reactive B-cell lymphocytosis and 89 cases of sIg negative mature B-cell lymphomas. The expression patterns of sIg and cytoplasmic immunoglobulin (cIg) light chains were studied by flow cytometry using both monoclonal and polyclonal antibodies. ResultsThese 14 cases of sIg negative reactive B-cell lymphocytosis were proven to be polytypic based on cytoplasmic light chain studies. In 89 cases of sIg negative mature B-cell lymphomas, we described four distinct patterns of abnormal light chain expression including partial or complete loss of sIg or cIg, suggesting different underlying mechanisms. ConclusionsThis study represents the first reported series of body or cystic fluids where reactive B cells do not have detectable sIg, arguing strongly against making a diagnosis of B-cell lymphoma based on lack of sIg in mature B cells. Since the lack of sIg does not always predict clonal/neoplastic mature B-cell proliferation, further cIg evaluation should be performed when sIg expression is not detected in mature B cells. The lack of both sIg and cIg in mature B cells may serve as a reliable surrogate clonality/neoplastic marker.
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