The cut-off levels of CD23 expression in the differential diagnosis of MCL and CLL

Flow cytometric analysis of CD23 expression in CD5‐positive B‐cells is a widely applied method in the differential diagnosis of chronic lymphocytic leukaemia (CLL) and mantle cell lymphoma (MCL). According to the most accepted criteria, the leukaemic cell population is CD19/CD5/CD23 triple positive in CLL but CD23‐negative in MCL. Recently, several groups have reported CD23‐positive MCL cases; however, these studies mostly analysed only CD23 positivity but not intensity. To determine the role and the cut‐off levels of CD23 positivity and intensity in the differential diagnosis of CLL and MCL, 26 cases of MCL and 84 cases of CLL were compared using flow cytometric analysis. Our results suggest that high values of CD23 positivity (>92.5%) and/or high fluorescence intensity (>44.5 mean fluorescence intensity (MFI)) of CD23 are related to CLL, whereas low CD23 positivity (