3. • Common in elderlies of age 60 and 80 years, with an unknown
aetiology.
• CLL or also known as B cell disease is characterized by the
infiltration of small lymphocytes in the BM.
• Tumour cell appears to mature B cell with weak surface
expression of IgM or IgD immunoglobulin.
• Cells accumulates in liver, spleen, blood, BM, and lymph nodes,
which increases production and prolongs lifespan with impaired
apoptosis.
3
Chronic lymphoid leukaemias
6. • Similar to CLL, but has the appearance of
prolymphocytes in blood.
• These prolymphocytes is twice the size of
CLL lymphocytes with central nucleolus.
• B-cell PLL is greater than T=cell PLL.
• PLL is characterized by massive
splenomegaly, without lymphadenopathy.
• Anaemia is a poor prognostic, but
lymphocyte count is high.
6
B-cell prolymphocytic leukaemia
(PLL
7. • Uncommon B-cell lymphoproliferative disorder of
male dominance (40-60 years).
• Anaemia, infection and splenomegaly and
lymphadenopathy is very uncommon.
• Present of pancytopenia and monocytopenia
• Variation number of lymphocytes present in blood
film with villous cytoplasmic projections.
• Flow cytometry reveals CD19+, CD5+, CD22, FMC7
and CD 103+.
• Stain +ve for TRAP
• BM shows mild fibrosis and diffuse cellular infiltrate.
7
Hairy cell leukaemia
8. • T-cell prolymphocytic leukaemia
• Similar to B-cell PLL, having elevated WCC
• Lymphadenopathy is more marked, skin lesions and
serous effusions are common
• CD4+
• Large granular lymphocytic leukaemia (LGL-L)
• Characterized by the present of circulating lymphocytes,
having abundant cytoplasm and large azurophilic
granules.
• Expression of CD16, CD56 and CD57.
• Cytopenia (neutropenia) is the main clinical problem.
• Anaemia, splenomegaly and arthropathy is common
8
T-cell diseases
9. • Associated with human
retrovirus, human T-cell
leukaemia/lymphoma virus
type 1.
• Lymphocytes of ATLL is
bizzare in morphology with
convoluted clover leaf
nucleus and consistent
CD4+ phenotype.
• Hypercalcaemia, skin
lessions,
hepatosplenomegaly and
lymphadenopathy.
• Prognosis is poor
9
Adult T-cell Leukaemia/lymphoma
(ATLL)