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Int J Clin Exp Pathol 2012;5(2):110-118

Original Article
Flow cytometric analysis of immunoglobulin heavy chains expression in B-cell
lymphoma and reactive lymphoid hyperplasia

David D Grier, Samer Z Al-Quran, Diana M Cardona, Ying Li, Raul C Braylan

Department of Pathology, University of Florida, College of Medicine, Gainesville, FL, USA; 1Dr. Grier is currently at the Department of Pathology,
Wake forest University School of Medicine, Winston-Salem, NC; 2Dr. Cardona is currently at the Department of Pathology, Duke University
Medical Center, Durham, NC; 3Dr. Braylan is currently the Chief of Hematology Laboratory, NIH/Clinical Center, Bethesda, MD 20892-1508;
*Drs. Al-Quran and Grier contributed equally to this work and share first authorship

Received December 27, 2011; accepted January 12, 2012; Epub February 12, 2012; Published February 28, 2012

Abstract: The diagnosis of B-cell lymphoma (BCL) is often dependent on the detection of clonal immunoglobulin (Ig) light chain expression. In
some BCLs, the determination of clonality based on Ig light chain restriction may be difficult. The aim of our study was to determine the utility of
flow cytometric analysis of surface Ig heavy chain (HC) expression in lymphoid tissues in distinguishing lymphoid hyperplasias from BCLs, and
also differentiating various BCL subtypes. HC expression on B-cells varied among different types of hyperplasias. Predominantly in follicular
hyperplasia, IgM and IgD expression was high in mantle cells while germinal center cells showed poor HC expression. In other hyperplasias,
B cell compartments were blurred but generally showed high IgD and IgM expression. Compared to hyperplasias, BCLs varied in IgM
expression. Small lymphocytic lymphomas had lower IgM expression than mantle cell lymphomas. Of importance, IgD expression was
significantly lower in BCLs than in hyperplasias, a finding that can be useful in differentiating lymphoma from reactive processes.

Keywords: Flow cytometry, lymphoid tissue, immunoglobulin heavy chains, lymphoma, reactive hyperplasia

Address all correspondence to:
Dr. Samer Z Al-Quran
Department of Pathology
University of Florida College of Medicine
P.O. Box 100275, Gainesville, FL 32610, USA.
Tel: (352) 265-9919; Fax: (352) 265-9918
E-mail: salquran@ufl.edu