Chronic lymphocytic leukemia/small lymphocytic lymphoma: another neoplasm related to the B-cell follicle?

Although there has been increased attention paid to the critical nature of nodal involvement in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), the B-cell compartment it is most closely related to and its relationship to the follicle remain uncertain. A clinicopathologic investiga...

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Bibliographic Details
Published in:Leukemia & lymphoma 2015-12, Vol.56 (12), p.3378-3386
Main Authors: Tandon, Bevan, Swerdlow, Steven H., Hasserjian, Robert P., Surti, Urvashi, Gibson, Sarah E.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
B-cell follicle
B-Lymphocytes - metabolism
B-Lymphocytes - pathology
Biomarkers - metabolism
Chromosome Aberrations
chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)
Dendritic Cells
Diagnosis, Differential
Female
follicular dendritic cells
Germinal Center - metabolism
Germinal Center - pathology
Humans
Immunoglobulin Heavy Chains - genetics
Immunohistochemistry
Immunophenotyping
Leukemia, Lymphocytic, Chronic, B-Cell - diagnosis
Leukemia, Lymphocytic, Chronic, B-Cell - genetics
Leukemia, Lymphocytic, Chronic, B-Cell - pathology
Lymphoma, B-Cell - diagnosis
Lymphoma, B-Cell - genetics
Lymphoma, B-Cell - pathology
Male
Middle Aged
Mutation
Neoplasm Staging
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Summary:Although there has been increased attention paid to the critical nature of nodal involvement in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), the B-cell compartment it is most closely related to and its relationship to the follicle remain uncertain. A clinicopathologic investigation of 60 extramedullary biopsies of LEF1+ CLL/SLL, including 29 cases with perifollicular/follicular (PF/F) growth, was therefore performed. A subset of PF/F cases demonstrated inner mantle zone preservation or intra-mantle zone growth. All PF/F and 16/31 other cases contained CD21+ follicular dendritic cells. No cytogenetic, IGHV mutational or gene usage differences were seen between PF/F and diffuse cases. PF/F cases were more often kappa positive (p < 0.03) and had fewer involved nodal sites (p = 0.0004). These findings suggest that at least a subset of bona fide CLL/SLL is related to the follicle, most likely the outer mantle zone, and that at least a subset of the diffuse cases may represent "later" disease.
ISSN:1042-8194
1029-2403
DOI:10.3109/10428194.2015.1037759