See Table 55–5 for the immunophenotype of chronic B-cell leukemias/lymphomas.
Monoclonal lymphocytosis versus causes of polyclonal lymphocytosis (see Chap. 49)
Prolymphocytic leukemia (see discussion later in this chapter)
— More than 50% of circulating leukemic lymphocytes have prolymphocytic morphology, with a larger size than CLL cells and a prominent nucleolus.
— There are high levels of CD79b and surface immunoglobulin and low levels of CD5.
Hairy cell leukemia (see Chap. 56)
Lymphomas with circulating neoplastic cells (see Chap. 60)
Small cell lymphocytic lymphoma
— Low-grade small lymphocytic B-cell lymphoma is closely related to B-cell CLL in its biology and clinical features.
— There is lymph node involvement.
— There is no overt blood or marrow involvement.
Mantle cell lymphoma (see Chap. 62)
— It expresses many of the same surface antigens as CLL B cells.
— It does not express CD23.
— The t(11;14) is characteristic of mantle cell lymphoma.
Splenic marginal zone lymphoma (SMZL) (see Chap. 63)
— This is commonly called splenic lymphoma with villous lymphocytes.
— SMZL has a mature B-cell phenotype and expresses IgM and IgD but typically lacks expression of CD23, CD43, CD10, BCL-6, and cyclin D.
— Neoplastic B cells have weak or absent expression of CD5
Lymphomas of follicular center cell origin (see Chap. 61)
— Small cleaved cell lymphomas express the CD10 (CALLA) antigen.
Lymphoplasmacytic leukemias
— These express CD38, PCA-1, CD56, and CD85, but there is low-level or lack of expression of CD19, CD20, CD24, CD72, and HLA-DR.
Waldenström macroglobulinemia (see Chap. 69)
Myeloma (see Chap. 68)
T-cell lymphoproliferative disorders (see Chap. 66)
T-cell CLL and T-cell prolymphocytic leukemia (see discussion later in this chapter)
Large granular lymphocytic leukemia (see Chap. 57)
Adult T-cell leukemia/lymphoma (see Chap. 66)
Cutaneous T-cell lymphomas (see Chap. 65)