Mature B Cell Neoplasms (CD 19, 20, 10, 22)

Question 1

CLL (chronic lymphocytic leukemia)

Answer 1

-Presence of SMUDGE CELLS
-MOST COMMON leukemia in adults in western countries
-“soccerball/cobblestone pattern”
-Monoclonal B-Cell Phenotype (B-cell -markers)
-CD19, CD20, CD23
-Treatment: Anti-CD20 monoclonal antibody; Rituximab
- TARGETS B CELLS
-Coarse Chromatin

Question 2

PLL (prolymphocytic leukemia)

Answer 2

-Variation of CLL
-high number of morphologically immature larger lymphocytes
-Prolymphocytes
-Disease of elderly
-Smooth chromatin
-Massive splenomegaly, lymph nodes NOT enlarged (NO lymphadenopathy)
CD19, CD20, CD22, CD24
-Strongly express sIg (surface immunoglobulin)

Question 3

HCL (Hairy Cell)

Answer 3

-Leukemic reticuloendotheliosis
-Massive splenomegaly, NO lymphadenopathy
-“Hairy Cells”
-TRAP +
-BM: “Dry tap”, “Fried egg” appearance
CD20, CD25, CD103, sIg

Question 4

Burkitt’s Lymphoma

Answer 4

-Mature B Cells (aggressive cancer)
-Neoplastic cells “starry sky” appearance
-t(8;14)
-CD19, CD20, CD10; CD22
-fuliminant clinical presentation
-3 Subtypes: Endemic subtype, Sporadic Burkitt Lymphoma, Immunodeficiency associated

Question 5

FL (follicular lymphoma)

Answer 5

-t(14;18)
-CD19, CD20, CD10
-MOST COMMON Non-Hodgkins Lymphoma in the US
-Cells originating within germinal center
-Painless lymphadenopathy (enlarged lymph nodes w/o pain
-“Butt” cells, deep indentation (cleft)

Question 6

MCL (mantle cell lymphoma)

Answer 6

-t(11;14)
-CD19, CD20, CD5, CD23
-mantle zone of lymphoid follicle

Question 7

DCBCL (diffuse large b-cell lymphoma)

Answer 7

-Most common form of Non-Hodgkin’s Lymphoma
-Disease of the elderly
-Painless lymphadenopathy