B-cell Prolymphocytic Leukemia : Microscopic
Image Description
Microscopic Features: The diagnosis of B-cell prolymphocytic leukemia (B-PLL) is typically not made via tissue biopsy but by morphologic, immunophenotypic, and genetic analysis of peripheral blood. However, a tissue biopsy is useful in excluding other more common lymphoid malignancies such as mantle cell lymphoma and splenic marginal zone lymphoma which have overlapping features with B-PLL.
The prolymphocytes are uniform, intermediate to large size with moderate amount of cytoplasm, round or oval nucleus, and a prominent nucleolus. The bone marrow infiltrates are interstitial or nodular and show sheets of prolymphocytes. Spleen involved by B-PLL shows expansion of white pulp areas as well as infiltration of red pulp by prolymphocytes.
Lymph nodes involved by B-PLL (this image) show diffuse effacement of architecture by prolymphocytes. Unlike CLL, proliferation centers are not seen.
The prolymphocytes are uniform, intermediate to large size with moderate amount of cytoplasm, round or oval nucleus, and a prominent nucleolus. The bone marrow infiltrates are interstitial or nodular and show sheets of prolymphocytes. Spleen involved by B-PLL shows expansion of white pulp areas as well as infiltration of red pulp by prolymphocytes.
Lymph nodes involved by B-PLL (this image) show diffuse effacement of architecture by prolymphocytes. Unlike CLL, proliferation centers are not seen.