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

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{{ 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      = [[bone marrow]]/[[lymph nodes]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = common
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = good
| Other      =
| ClinDDx    =
| Tx        =
}}
'''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]]. That typically afflicts older individuals.


Revision as of 11:24, 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. That typically afflicts older individuals.

General

  • Very common.
  • Good prognosis.

Richter's transformation

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

Microscopic

Features in a lymph node:[2]

  • 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

  • CLL - low mag. (WC)

  • CLL - intermed. mag. (WC)

  • CLL - high mag. (WC)

  • CLL - very high mag. (WC)

www:

IHC

  • CD20 +ve.
  • CD5 +ve.
  • CD23 +ve -- occasionally negative.[3]
  • CD43 +ve.

Others:

  • Cyclin D1 -ve.

Molecular

See also

References

  1. ↑ 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.
  2. ↑ DG. 17 August 2010.
  3. ↑ URL: http://path.upmc.edu/cases/case296/dx.html. Accessed on: 14 January 2012.
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