Difference between revisions of "B cell small lymphocytic lymphoma/chronic lymphocytic leukemia"

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'''B cell small lymphocytic lymphoma/chronic lymphocytic leukemia''', often referred to as '''chronic lymphocytic leukemia''' (abbreviated '''CLL''') or '''small lymphocytic lymphoma''' (abbreviated '''SLL'''), is a common low-grade hematologic [[malignancy]]. That typically afflicts older individuals.
'''B cell small lymphocytic lymphoma/chronic lymphocytic leukemia''', often referred to as '''chronic lymphocytic leukemia''' (abbreviated '''CLL''') or '''small lymphocytic lymphoma''' (abbreviated '''SLL'''), is a common low-grade hematologic [[malignancy]]. It typically afflicts older individuals.


==General==
==General==
*Very common.
*Very common.
*Good prognosis.
*Good prognosis - treatment may be simply followup.<ref name=pmid12676780>{{cite journal |author=Guarini A, Gaidano G, Mauro FR, ''et al.'' |title=Chronic lymphocytic leukemia patients with highly stable and indolent disease show distinctive phenotypic and genotypic features |journal=Blood |volume=102 |issue=3 |pages=1035–41 |year=2003 |month=August |pmid=12676780 |doi=10.1182/blood-2002-12-3639 |url=}}</ref>
**May transform to an aggressive lymphoma - see below.
*Older individuals.
*Elevated WBC.


===Richter's transformation===
===Richter's transformation===
Line 71: Line 74:
Others:
Others:
*Cyclin D1 -ve.  
*Cyclin D1 -ve.  
*CD38 -ve/+ve.
**CD38 -ve suggests a good prognosis.<ref name=pmid12676780>{{cite journal |author=Guarini A, Gaidano G, Mauro FR, ''et al.'' |title=Chronic lymphocytic leukemia patients with highly stable and indolent disease show distinctive phenotypic and genotypic features |journal=Blood |volume=102 |issue=3 |pages=1035–41 |year=2003 |month=August |pmid=12676780 |doi=10.1182/blood-2002-12-3639 |url=}}</ref>


==Molecular==
==Molecular==

Revision as of 12:49, 10 June 2014

B cell small lymphocytic lymphoma/chronic lymphocytic leukemia
Diagnosis in short

Small lymphocytic lymphoma. H&E stain.

LM mixed population of lymphoid cells with "proliferation centers": (1) nodular collections of larger cells (~ 1.5x the size of resting lymphocyte ~ 12-15 micrometers) with nucleoli) - surrounded by (2) small dark cells (~ size of resting lymphocyte ~ 8-10 micrometers) - predominant population, lack nucleolus
LM DDx other small cell lymphomas esp. mantle cell lymphoma (IHC similar)
IHC CD20 +ve, CD23 +ve, CD5 +ve, cyclin D1 -ve, CD43 +ve
Site bone marrow/lymph nodes

Prevalence common
Prognosis good

B cell small lymphocytic lymphoma/chronic lymphocytic leukemia, often referred to as chronic lymphocytic leukemia (abbreviated CLL) or small lymphocytic lymphoma (abbreviated SLL), is a common low-grade hematologic malignancy. It typically afflicts older individuals.

General

  • Very common.
  • Good prognosis - treatment may be simply followup.[1]
    • May transform to an aggressive lymphoma - see below.
  • Older individuals.
  • Elevated WBC.

Richter's transformation

  • CLL/SLL may under go a Richter's transformation into a high-grade non-Hodgkin's lymphoma (NHL), e.g. DLBCL:[2]
    • Incidence of transformation <5%.
    • Prognosis < 1 year.

Microscopic

Features in a lymph node:[3]

  • Mixed population of lymphoid cells with "proliferation centers" - key feature:
    1. Larger cells (~ 1.5x the size of resting lymphocyte ~ 12-15 micrometers):
      • Nucleoli.
      • Form (nodular) collections.
    2. Small dark cells (~ size of resting lymphocyte ~ 8-10 micrometers):
      • Predominant population.
      • Lack nucleolus.

Images

www:

IHC

  • CD20 +ve.
  • CD5 +ve.
  • CD23 +ve -- occasionally negative.[4]
  • CD43 +ve.

Others:

  • Cyclin D1 -ve.
  • CD38 -ve/+ve.
    • CD38 -ve suggests a good prognosis.[1]

Molecular

See also

References

  1. 1.0 1.1 Guarini A, Gaidano G, Mauro FR, et al. (August 2003). "Chronic lymphocytic leukemia patients with highly stable and indolent disease show distinctive phenotypic and genotypic features". Blood 102 (3): 1035–41. doi:10.1182/blood-2002-12-3639. PMID 12676780.
  2. Tsimberidou AM, Keating MJ (April 2006). "Richter's transformation in chronic lymphocytic leukemia". Semin. Oncol. 33 (2): 250–6. doi:10.1053/j.seminoncol.2006.01.016. PMID 16616072.
  3. DG. 17 August 2010.
  4. URL: http://path.upmc.edu/cases/case296/dx.html. Accessed on: 14 January 2012.