Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
Updated: 09/16/2024
© Jun Wang, MD, PhD

General features
  • Indolent, usually old patients
  • Predominantly B cell lymphoma,  rarely T-cell origin
  • Associated with warm autoimmune hemolytic anemia in up to one third patients
  • Small lymphocytic lymphoma: Localized tumor
  • Chronic lymphocytic leukemia: > 5 x 109/L neoplastic small lymphocytes in peripheral blood
  • Monoclonal B cell lymphocytosis: < 5 x 109/L neoplastic small lymphocytes in peripheral blood
  • May transform to high grade lymphoma, such as diffuse large B cell lymphoma (Richter syndrome)
Clinical presentations
  • Non specific, including lymphadenopathy, etc
Key Laboratory findings
  • Lymphocytosis if leukemia
  • Small lymphocytic infiltrate if lymphoma
Key morphological features of tumor cells
  • Small lymphocytes with scant cytoplasm
  • Condensed chromatin with “Soccer ball” appearance
  • "Smudge/basket" cells may present but not specific 
  • Sheet of monotonous small lymphocytes if SLL
Markers
  • Positive: CD5, CD23, CD19, CD20, CD200, light chain restriction
  • Negative: CD10, cyclin D1
Genetic abnormalities
  • MIR15A/MIR16A microRNAs: Deletion
  • Others
Negative prognosis indicator
  • Positive: ZAP 70


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