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Author Notes:

To whom correspondence should be addressed: Silvia T. Bunting, silvia.bunting@choa.org.



  • Science & Technology
  • Life Sciences & Biomedicine
  • Medical Laboratory Technology
  • flow cytometry
  • hematopathology
  • hematogones
  • light-chain restriction
  • Lambda light chain
  • lymphoproliferative disorders

Hematogones With Lambda Light Chain Restriction in a 4-Year-Old Boy With Burkitt Lymphoma: A Potential Diagnostic Pitfall


Journal Title:

Laboratory Medicine


Volume 47, Number 2


, Pages 163-170

Type of Work:

Article | Final Publisher PDF


Hematogones are immature normal B cell precursors with a characteristic immunophenotype profile on flow cytometry that typically do not express surface immunoglobulin light chains. In this report, we describe a case in which the hematogones exhibit light chain restriction. Our patient was a 4-year-old boy with a complicated medical history involving treatment for a presumed bilateral Wilms tumor of the kidney that on later resection was diagnosed as Burkitt lymphoma. Flow cytometry analysis of his bone marrow revealed a small distinct population of cells expressing dim cluster of differentiation (CD)10, CD19, CD22, CD38, dim CD58, human leukocyte antigen-D related (HLA-DR), and dim CD45, which are characteristic of hematogones. These cells, however, demonstrated dim surface immunoglobulin lambda light-chain restriction. Molecular study results for immunoglobulin heavy and kappa light-chain gene rearrangements were negative. We present this case to raise awareness of the potential pitfalls of working up bone marrow for involvement by B cell lymphoproliferative disorder.

Copyright information:

© American Society for Clinical Pathology, 2016.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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