Chronic lymphocytic leukemia/small cell lymphoma (CLL/SLL)

​

CLL is the most common mature B-cell leukemia in the Western hemisphere and makes up 30% of all leukemias. It mainly affects middle-aged and elderly patients with a male predominance. The neoplastic cells are predominantly in blood and bone marrow. CLL is asymptomatic in most patients and often detected incidentally on complete blood counts. The diagnosis requires absolute mature lymphocytosis of ≥ 5.0 x 109/L sustained for at least 3 months.  In contrast to CLL, SLL is much less common, making up only about 4% of non-Hodgkin lymphomas. The distribution of the neoplastic cells in SLL is mainly extramedullary with very few leukemic cells in blood. The patients are often asymptomatic but may present with lymphadenopathy and splenomegaly.

​

Immunophenotype:

​

Multicolor flow cytometry shows the following results in a typical case: mature B-cell phenotype with weak monotypic surface immunoglobulin, CD5 coexpression, weak CD20, weak CD22, CD23, CD19, weak CD11c; negative for CD10, FMC7, and CD79b.

​

Case-1

​

​

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

        Above case shows (lymp-red, grans-blue, Monocytes- pink) positivity for CD19, CD5, CD23, CD200, L restricted and negativity for kappa, CD20 ,CD10

 

​

​

      Case-2

 

 

 

 

​

​

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Above case shows (lymp-red, grans-blue, Monocytes- pink) positivity for CD19, CD5, CD23, K restricted and negativity for Lambda, CD20 ,CD10, CD3, FMC-7, CD38

 

 

Reference:

• werdlow SH, Campo E, Harris NL, et al., editors. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC; 2008.

• Müller-Hermelink HK, Montserrat E, Catovsky D, et al. Chronic lymphocytic leukaemia/small lymphocytic lymphoma. In: Swerdlow SH, Campo E, Harris NL, et al., editors. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC Press; 2008. pp. 180–182.

• Swerdlow SH, Campo E, Seto M, et al. Mantle cell lymphoma. In: Swerdlow SH, Campo E, Harris NL, et al., editors. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC; 2008. pp. 229–232.

• Lampert IA, Wotherspoon A, Van Noorden S, et al. High expression of CD23 in the proliferation centers of chronic lymphocytic leukemia in lymph nodes and spleen. Hum Pathol. 1999;30:648–654. [PubMed]

• Soma LA, Craig FE, Swerdlow SH. The proliferation center microenvironment and prognostic markers in chronic lymphocytic leukemia/small lymphocytic lymphoma. Hum Pathol. 2006;37:152–159. [PubMed]

• Bertilaccio MT, Scielzo C, Muzio M, et al. An overview of chronic lymphocytic leukaemia biology. Best Pract Res Clin Haematol. 2010;23:21–32. [PubMed]

• Caligaris-Cappio F, Chiorazzi N. Where is the biology of CLL leading us? Semin Cancer Biol. 2010;20:361–362. [PubMed]

• Zenz T, Mertens D, Kuppers R, et al. From pathogenesis to treatment of chronic lymphocytic leukaemia. Nat Rev Cancer. 2010;10:37–50. [PubMed]

• Klein U, Dalla-Favera R. New insights into the pathogenesis of chronic lymphocytic leukemia. Semin Cancer Biol. 2010;20:377–383. [PubMed]

• Bonato M, Pittaluga S, Tierens A, et al. Lymph node histology in typical and atypical chronic lymphocytic leukemia. Am J Surg Pathol. 1998;22:49–56. [PubMed]

• Giné E, Martinez A, Villamor N, et al. Expanded and highly active proliferation centers identify a histological subtype of chronic lymphocytic leukemia (“accelerated” chronic lymphocytic leukemia) with aggressive clinical behavior. Haematologica. 2010;95:1526–1533. [PMC free article] [PubMed]