Case 9- Discussion

Uploaded: 2007-06-09, Updated: 2007-06-19






Clinical Futures

  • B-PLL de novo: prolymphocytes > 55%of all lymphoid cells in peripheral blood, more aggressive than B-CLL;

  • B-CLL/PLL: mixed B-CLL and PLL (<55%);

  • B-CLL progression: PLL >55% with a history of CLL. Only 50% cases have an identical gene arrangement, and therefore 50% cases represent a second leukemic clone; worse prognosis;

  • Most de novo B-PLL have splenomegaly, but in contrast to B-CLL, no adenopathy.

Microscopic Findings

  • Medium to large cells with a moderate amount of cytoplasm;

  • Condensed chromatin (more open than CLL) with prominent central nucleoli.



Differential Diagnosis


Immunohistochemistry Straining

  • PLL arising from CLL: CD5+; de novo PLL: CD5-;

  • CD20 and sIg: moderate, not as dim as in B-CLL;

  • Many cases CD23-;



Treatment and Prognosis



  • Flow cytometry in neoplastic hematology. Wojciech Gorczyca. 2006