CD10 positive B cell lymphoma

by Jason Wasserman MD PhD FRCPC and Kamran M. Mirza MBBS PhD
December 16, 2024

This article is designed to help you understand your pathology report for CD10 positive B cell lymphoma. Each section explains an important aspect of the diagnosis and what it means for you.

What is CD10 positive B cell lymphoma?

CD10 positive B cell lymphoma describes a group of immune system cancers involving B cells that express a protein called CD10. This group includes both indolent (slow-growing) and aggressive cancers. Additional tests are usually performed to refine the diagnosis further.

What cancers are included in CD10 positive B cell lymphoma?

Several types of B cell lymphoma can express CD10, including:

These types of lymphoma have different behaviors and treatments, so it’s important to determine which one is present.

How do pathologists distinguish between these types?

The appearance of the cancer cells can vary depending on the type of CD10 positive B cell lymphoma. For this reason, pathologists examine the tissue sample under a microscope to look at the size, shape, and arrangement of the cancer cells. They also use special tests, such as immunohistochemistry, to identify markers on the surface of the cells.

Microscopic features

    • Follicular lymphoma: The cancer cells in follicular lymphoma are typically small to medium-sized with a round shape and form structures called follicles, resembling normal lymph nodes. High-grade (grade 2 or 3) follicular lymphoma may have larger, more irregular cells and can look similar to diffuse large B cell lymphoma.
    • Diffuse large B cell lymphoma (DLBCL): The cancer cells in diffuse large B cell lymphoma are larger and spread diffusely (without forming follicles) through the lymph node or tissue.
    • Burkitt lymphoma: The cancer cells in Burkitt lymphoma are medium-sized, uniform, and grow very rapidly. The background often shows a “starry sky” pattern due to scattered macrophages eating dead cells.
    • B lymphoblastic leukemia/lymphoma: The cancer cells in both B lymphoblastic leukemia and B lymphoblastic lymphoma are small, immature, and have a high nucleus-to-cytoplasm ratio (the nucleus takes up most of the cell).
    • High-grade B cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements: High-grade B cell lymphoma often has large, aggressive-looking cells that divide rapidly, with features overlapping those of DLBCL and Burkitt lymphoma.

Additional tests

  • Immunohistochemistry: Immunohistochemistry uses special stains to highlight proteins like CD10. Other markers, such as BCL6, MYC, and Ki-67 (a marker of cell division), may also be tested to gather more information about the cancer.
  • Fluorescence in situ hybridization (FISH): FISH looks for genetic changes, such as rearrangements in the MYC, BCL2, and BCL6 genes, which are important for diagnosing specific lymphoma subtypes.
  • Next-generation sequencing (NGS): NGS examines many genes at once to identify mutations or other changes in the cancer cells that might affect treatment options.
  • Polymerase chain reaction (PCR): PCR looks for specific genetic rearrangements or mutations, providing additional clues about the type of cancer.

These tests allow pathologists to refine the diagnosis and identify the exact type of CD10 positive B cell lymphoma.

Why are these additional tests important?

The exact type of CD10 positive B cell lymphoma determines the best treatment and prognosis. For example:

By using advanced tests, doctors can develop a personalized treatment plan tailored to your specific type of lymphoma.

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