Stains & CD markers
CD23


Last author update: 3 March 2022
Last staff update: 3 March 2022

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PubMed Search: CD23[TI] review[PT]

Mihaly Sulyok, M.D., Ph.D.
Christian M. Schürch, M.D., Ph.D.
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Cite this page: Sulyok M, Schürch CM. CD23. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cdmarkerscd23.html. Accessed December 9th, 2022.
Definition / general
Essential features
  • CD23 is a low affinity IgE receptor
  • Differentiates small lymphocytic lymphoma (SLL) / chronic lymphocytic leukemia (CLL) (CD23+) from mantle cell lymphoma or MALT lymphoma (CD23-)
  • B cell marker, particularly for SLL / CLL, mediastinal large B cell lymphoma, lymphoplasmacytic lymphoma and diffuse follicular lymphoma (Mod Pathol 2012;25:1637, Blood Adv 2020;4:5652)
  • Distinguish nodal marginal zone lymphoma from follicular lymphoma by identifying a disrupted follicular dendritic cell pattern (Int J Surg Pathol 2005;13:73)
Terminology
  • Low affinity IgE receptor, Fc fragment of IgE receptor, FCER
Pathophysiology
  • Secretable type C lectin
  • After physiologic germinal cell development, the follicular dendritic cell meshwork expands and follicular dendritic cells in the light zone of the germinal center become CD23 positive
  • CD23 acts as a B cell growth and activation factor, promoting differentiation into plasma cells
  • Shows variability in flow cytometry expression between specimens from same patient (Am J Clin Pathol 2002;117:615)
  • CD21, CD23 and CD35 are dendritic cell markers
  • Interactions with IgE:
  • CD23 is noncovalently associated with HLA-DR and plays a role in endocytosis and recycling of the complex, which may contribute to the efficiency of antigen presentation (Immunology 2001;103:319)
Clinical features
Interpretation
  • Diffuse cell membrane staining, cytoplasmic staining
Uses by pathologists
  • CD21, CD23 and CD35 are follicular dendritic cell markers
  • Differentiate SLL / CLL (CD23+) versus mantle cell lymphoma or MALT lymphoma (CD23-)
  • B cell marker, particularly for SLL / CLL, mediastinal large B cell lymphoma, lymphoplasmacytic lymphoma and diffuse follicular lymphoma (Mod Pathol 2012;25:1637, Blood Adv 2020;4:5652)
  • Distinguish nodal marginal zone lymphoma from follicular lymphoma by identifying a disrupted follicular dendritic cell pattern in marginal zone lymphoma (Int J Surg Pathol 2005;13:73)
Microscopic (histologic) images

Contributed by Mihaly Sulyok, M.D., Ph.D. and Christian M. Schürch, M.D., Ph.D.

CLL / SLL

Follicular lymphoma

Tonsilla

Virtual slides

Images hosted on other servers:

CD23 positive FDCs of germinal centers

CD23 positive nodal infiltrate of CLL / SLL

Positive staining - normal
Positive staining - disease
Negative staining
Sample pathology report
  • Left axillary lymph node, excision:
    • Left axillary lymph node excision infiltrated by chronic lymphocytic leukemia / small lymphocytic lymphoma (CLL / SLL) with large proliferation centers; no signs of Richter transformation (see comment)
    • Comment: A large lymph node with disrupted architecture due to a lymphocytic infiltrate with a vaguely nodular growth pattern. The infiltrate consists of small cells with round nuclei, mature chromatin and a barely visible cytoplasmic border. The nodular parts (so called proliferation centers) consist of small and large cells and some large prominent paraimmunoblasts.
    • Immunohistochemically, the infiltrate is positive for CD20, CD5, CD23 and BCL2. The staining for CD3 shows numerous accompanying reactive T lymphocytes. The stains for cyclin D1, BCL6 and CD10 remain negative in the lymphocytic infiltrate but BCL6 and CD10 are positive in a few residual reactive germinal centers. The proliferation is high and polarized in the residual germinal centers and somewhat increased in the proliferation centers with a proliferation rate of about 20%.
Board review style question #1
Which tumor typically exhibits CD23 positivity?

  1. Blastic plasmacytoid dendritic cell neoplasm
  2. Follicular dendritic cell sarcoma
  3. HHV8 associated germinotropic lymphoproliferative disorder
  4. Indeterminate dendritic cell tumor
  5. Interdigitating dendritic cell sarcoma
Board review style answer #1
B. Follicular dendritic cell sarcoma

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Reference: CD23
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