Huang J C, Finn W G, Goolsby C L, Variakojis D, Peterson L C
Northwestern University Medical School, Chicago, Illinois, USA.
Am J Clin Pathol. 1999 Jan;111(1):123-30. doi: 10.1093/ajcp/111.1.123.
Expression of the CD5 antigen by neoplastic cells often is considered a diagnostic criterion for B-cell chronic lymphocytic leukemia (B-CLL). However, published series frequently include a number of CD5- cases. We studied the spectrum of CD5- B-cell lymphoproliferative disorders presenting with leukemia involvement and reassessed the prevalence of CD5- B-CLL. We immunophenotyped 192 cases of clonal, small lymphocytic, B-cell disorders involving peripheral blood or bone marrow. Of these, 41 CD5- cases were further analyzed, correlating the immunophenotypic findings with pathologic material and clinical data. Only 3 CD5- cases were classified as CD5- B-CLL. These 3 cases had features unusual for B-CLL, including bright surface immunoglobulin expression, bright CD20 expression, and absence of CD23 expression (2 cases) or Richter syndrome (1 case). The remainder of the CD5- cases consisted of hairy cell leukemia, hairy cell variant, prolymphocytic leukemia, follicular center cell lymphoma, lymphoplasmacytic lymphoma, splenic marginal zone lymphoma (SMZL), small lymphocytic lymphoma with marrow fibrosis, and lymphoma, not further classified. Eight cases remained unclassified, but some displayed features of SMZL. CD5- lymphoproliferative disorders of peripheral blood or bone marrow are unlikely to be CLL and often are classified more appropriately as non-Hodgkin lymphoma in the leukemia phase.
肿瘤细胞表达CD5抗原通常被视为B细胞慢性淋巴细胞白血病（B-CLL）的诊断标准。然而，已发表的系列研究中常常包含一些CD5阴性的病例。我们研究了伴有白血病累及的CD5阴性B细胞淋巴增殖性疾病的谱系，并重新评估了CD5阴性B-CLL的患病率。我们对192例涉及外周血或骨髓的克隆性、小淋巴细胞性B细胞疾病进行了免疫表型分析。其中，对41例CD5阴性病例进行了进一步分析，将免疫表型结果与病理材料及临床数据相关联。仅有3例CD5阴性病例被归类为CD5阴性B-CLL。这3例病例具有一些B-CLL不常见的特征，包括明亮的表面免疫球蛋白表达、明亮的CD20表达以及CD23表达缺失（2例）或Richter综合征（1例）。其余的CD5阴性病例包括毛细胞白血病、毛细胞变异型、幼淋巴细胞白血病、滤泡中心细胞淋巴瘤、淋巴浆细胞淋巴瘤、脾边缘区淋巴瘤（SMZL）、伴有骨髓纤维化的小淋巴细胞淋巴瘤以及未进一步分类的淋巴瘤。8例病例未分类，但有些表现出SMZL的特征。外周血或骨髓的CD5阴性淋巴增殖性疾病不太可能是CLL，通常更适合归类为白血病期的非霍奇金淋巴瘤。
