Cytometry
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Cytometry is the quantification and measurement of cells.
It is typically done in the context of lymphoma via one of two techniques:
- Flow cytometry.
- Laser scanning cytometry (LSC).
Common markers
- CD3, CD4, CD8, CD5, CD7.
- CD19, CD20, FMC7.
- Kappa, lambda.
Normal
- T-cells to B-cells usually 1:1.
- In reactive nodes T-cells predominate.
- Normal thymic tissue has cells that are positive for both CD4 and CD8.
- Kappa (k) and lambda (l) are not expressed by the same cell.
- Rule-of-thumb for normal k:l range is: <6:1 and 1:<3.[1]
- Lambda dominance is less common.
GS guidelines - non-malignant is:[2]
- CD19 ~= CD20.
- CD5 = CD3.
- CD2 > CD3 and CD5.
- CD4 + CD8 ~= CD3.
- CD7 = the smallest number of T-cell.
Abnormal
- CD4>CD8 predominance classically seen in:
- T cell lymphoma - loss of one of the T-cell markers (CD2, CD3, CD5 or CD7).
- CD7 is usually the first to be lost.
Sample report
B-Cell Associated Markers
- CD10.
- Germinal centre marker.
- +ve in: follicular lymphoma, Burkitt lymphoma, precursor lymphoblastic leukemia.
- CD19.
- B cell marker.
- Should be ~=CD20.
- CD20.
- B cell marker.
- Should be ~=CD20.
- CD23.
- +ve in CLL/SLL.
- FMC7
- B cell marker.
- Kappa+CD19/20+.
- B cell clonality.
- Lambda+CD19/20+
- B cell clonality.
T-Cell Associated Markers
- CD3.
- CD3 ~= CD4 + CD8.
- Usually: CD2 > CD3 > CD7.
- CD5.
- Usually: CD2 > CD5 > CD7.
- CD4.
- CD3 ~= CD4 + CD8.
- CD8.
- CD3 ~= CD4 + CD8.
- CD7.
- Usually least prevalent T cell marker; < CD2, < CD3, < CD5.
- CD2.
- Usually most prevalent T cell marker; > CD3, > CD5, > CD7.
NK-Cell Associated Markers
- CD56.
- CD16.
Miscellaneous Markers
- CD11c -- usu. +ve in marginal zone lymphoma.
- CD14.