CLL


Expand All | Collapse All

  • Names

    • CLL for leukemia
    • SLL for lymphoma

  • Clinical

    • most common leukemia in US
    • mean age 65
    • site: blood, marrow, nodes, liver, spleen
    • RAI staging system

  • Labs

    • must have 5E9 monoclonal lymphocytes in peripheral blood
    • otherwise, it's monoclonal B cell lymphocytosis

  • Morphology

    • predominantly small lymphocytes (look for large cell transformation)
      • 5% develop DLBCL
      • < 1% develop Hodgkin
    • lymph nodes: regular spaced (pseudofollicular) proliferation centers
      • proliferation centers: pale larger cells
      • background: dark smaller cells
    • Smear: smudge cells
    • prolymphocytes (larger cells with prominent nucleoli) < 2%

  • Stains

    • positive: CD5, CD23, LEF1

  • Molecular

    • mutated IGHV: better prognosis
    • unmutated IGHV, immature: poor prognosis, ZAP70 expression
    • common cytogenetic abn: del 13q14.3 (50%), trisomy 12 (20%), del 17p
    		•