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Difference between revisions of "B cell small lymphocytic lymphoma/chronic lymphocytic leukemia"
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B cell small lymphocytic lymphoma/chronic lymphocytic leukemia (view source)
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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]]. | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Chronic lymphocytic leukemia - low mag.jpg | |||
| Width = | |||
| Caption = Small lymphocytic lymphoma. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = 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 | |||
| Subtypes = | |||
| LMDDx = other [[small cell lymphomas]] esp. [[mantle cell lymphoma]] (IHC similar) | |||
| Stains = | |||
| IHC = CD20 +ve, CD23 +ve, CD5 +ve, cyclin D1 -ve, CD43 +ve | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = blood + [[bone marrow]]/[[lymph nodes]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = common | |||
| Bloodwork = elevated WBC (≥5 × 10<sup>9</sup>/L) | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = good | |||
| Other = | |||
| ClinDDx = | |||
| Tx = often followup | |||
}} | |||
'''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 ≥5 × 10<sup>9</sup>/L - required for diagnosis (clinically).<ref>{{cite journal |author=Call TG, Norman AD, Hanson CA, ''et al.'' |title=Incidence of chronic lymphocytic leukemia and high-count monoclonal B-cell lymphocytosis using the 2008 guidelines |journal=Cancer |volume= |issue= |pages= |year=2014 |month=April |pmid=24711224 |doi=10.1002/cncr.28690 |url=}}</ref> | |||
===Richter's transformation=== | ===Richter's transformation=== | ||
| Line 40: | 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> | |||
===Panel=== | |||
A basic panel - based on ''Rizzo and Nassiri'':<ref name=lymphoma>{{Cite journal | last1 = Rizzo | first1 = K. | last2 = Nassiri| first2 = M. | title = Diagnostic Workup of Small B Cell Lymphomas: A Laboratory Perspective. | journal = Lymphoma | volume = | issue = | pages = | month = | year = 2012 | doi =doi:10.1155/2012/346084| PMID = }}</ref> | |||
*CD5, CD10, BCL6, CD23, cyclin D1. | |||
Additional IHC: | |||
*CD20, CD3, CD43, BCL2. | |||
==Molecular== | ==Molecular== | ||