Remember to check if internal and external controls are properly stained. (TdT with aberrant pattern and CDX2 deteriorated)
A) CD5. Weaker but still acceptable staining of non-neoplastic T-lymphocytes (internal control) and almost negative staining of neoplastic lymphocytes of B-CLL because of poorly calibrated protocol. External control shows that staining is insufficient. Repeated staining with adjusted protocol demonstrates as expected positive staining of neoplastic B-lymphocytes.
HE. Bone marrow with nodular lymphoid infiltrates and clinical query about lymphoma.
CD5. Bone marrow with nodular lymphoid infiltrates and clinical query about Chronic Lymphatic Leukemia or other type of lymphoma. Staining showes scattered small positive lymphocytes including some weakly stained cells. Internal control (T-lymphocytes) are clearly positive. Checking external control (tonsil) is necessary. 10x.
CD5. Bone marrow with nodular lymphoid infiltrates and clinical query about B-CLL. Staining showes scattered small positive lymphocytes including some weakly stained single cells. Internal control (T-lymphocytes) are clearly positive. Checking external control (tonsil) is necessary. High magnification.
CD5. Bone marrow with nodular lymphoid infiltrates and clinical query about Chronic Lymphatic Leukemia or other type of lymphoma. Staining of external control (tonsil) is not sufficient (to weak). The staining protocol has to be adjusted.
CD5. Staining of external control (tonsil) according to adjusted protocol is much stronger. Case of bone marrow with nodular lymphoid infiltrates and clinical query about lymphoma.
CD5. Bone marrow with nodular lymphoid infiltrates and clinical query about B-CLL. Staining according to adjusted protocol shows positive lymphocytes where internal control (T-lymphocytes) show stronger staining than surrounding positive B-lymphocytes. The immunoprofile included also positive staining for CD20 and CD23 – consisted with B-CLL.
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