CD23 (low affinity IgE receptor, Leu-20, FceRII) is a type II integral membrane glycoprotein, 45-60 kDa, and a member of an immunoglobulin supergene family. CD23 is a B-cell-specific antigen and it has essential roles in the regulation of IgE production and in the differentiation of B-cells. It also exists as a soluble excreted form that display autocrine promoting activity. In humans, main cellular expression of CD23 is found in B-lymphocytes (strong expression in activated germinal center B-cells, weaker staining of resting mantle zone B-cells), monocytes, follicular dendritic cells (FDCs) predominately in the apical light zone of the germinal center, but also on activated CD4+ T lymphocyte subset, platelets, eosinophils, neutrophils, and Langerhans cells. CD23 is upregulated in Eppstein-Barr infection. CD23 is constitutively expressed by intestinal epithelial cells and its expression is enhanced in enteropathies.


CD23 is typically expressed in chronic lymphocytic leukemia (CLL), sometimes in follicular lymphoma, rarely in marginal zone and lymphoplasmacytic lymphoma, but not in mantle cell lymphoma. In CLL, the strongest expression is characteristically present in proliferation centers. It was recently demonstrated that patients with CD23-positive diffuse large B-cell lymphoma have good prognosis. CD23 is also frequently used to demonstrate benign follicular dendritic cells in the background of follicular lymphoma, nodular lymphocyte predominant Hodgkin lymphoma, (intra)follicular T-cell lymphoma and other lymphomas. Together with CD21, CD23 is a marker of rare follicular dendritic cell tumors Some authors demonstrated CD23 expression in epithelial cells of nasopharyngeal carcinoma.


In diagnostic pathology CD23 is primarily used in the panel for small B-cell lymphoproliferative disorders.


Tonsil is recommended as positive and negative tissue control for CD23. The follicular dendritic cells of the germinal centres must be stained as strongly as possible without any staining reaction of squamous epithelial cells and T-cells in the interfollicular T-zones. In the mantle zone of the follicles, the majority of activated B-cells must show an at least weak to moderate and distinct continuous membranous staining reaction.  

Selected references

Bagdi E, Krenacs L, Krenacs T, Miller K, Isaacson PG. ollicular dendritic cells in reactive and neoplastic lymphoid tissues: a reevaluation of staining patterns of CD21, CD23, and CD35 antibodies in paraffin sections after wet heat-induced epitope retrieval. Appl Immunohistochem Mol Morphol. 2001 Jun;9(2):117-24. Chen CC, Raikow RB, Sonmez-Alpan E, Swerdlow SH. Classification of small B-cell lymphoid neoplasms using a paraffin section immunohistochemical panel. Appl Immunohistochem Mol Morphol. 2000 Mar;8(1):1-11. Fratazzi C, Carini C. Interleukin-7 modulates CD23 and HLA-DR expression on CD4+ T cells and promotes a Th-2 type citokine profile. Allergol Immunopathol (Madr). 1997 Jul-Aug;25(4):189-98. Kaiserlian D, Lachaux A, Grosjean I, Graber P, Bonnefoy JY. Intestinal epithelial cells express the CD23/Fc epsilon RII molecule: enhanced expression in enteropathies. Immunology. 1993 Sep;80(1):90-5. Lampert IA, Wotherspoon A, Van Noorden S, Hasserjian RP. High expression of CD23 in the proliferation centers of chronic lymphocytic leukemia in lymph nodes and spleen. Hum Pathol. 1999 Jun;30(6):648-54. Linderoth J, Jerkeman M, Cavallin-Stahl E, Kvaloy S, Torlakovic E. Immunohistochemical expression of CD23 and CD40 may identify prognostically favorable subgroups of diffuse large B-cell lymphoma: a Nordic Lymphoma Group Study. Clin Cancer Res. 2003 Feb;9(2):722-8. Rousselet G, Busson P, Billaud M, Guillon JM, Scamps C, Wakasugi H, Lenoir G, Tursz T. Structure and regulation of the blast-2/CD23 antigen in epithelial cells from nasopharyngeal carcinoma. Int Immunol. 1990;2(12):1159-66. Watson P, Wood KM, Lodge A, McIntosh GG, Milton I, Piggott NH, Proctor SJ, Taylor PR, Smith S, Jack F, Bell H, Steward M, Anderson JJ, Horne CH, Angus B. Monoclonal antibodies recognizing CD5, CD10 and CD23 in formalin-fixed, paraffin-embedded tissue: production and assessment of their value in the diagnosis of small B-cell lymphoma. Histopathology. 2000 Feb;36(2):145-50. Xu Y, McKenna RW, Asplund SL, Kroft SH. Comparison of immunophenotypes of small B-cell neoplasms in primary lymph node and concurrent blood or marrow samples. Am J Clin Pathol. 2002 Nov;118(5):758-64. Zong YS, Lin H, Choy DT, Sham JS, Wei W, Chan KH, Ng MH. Nasopharyngeal carcinoma and lymphoinfiltration. Oncology. 1991;48(4):290-6.

13.03.12 - ET/MV/LE