Proliferation centers in bone marrows involved by chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL): a clinicopathologic analysis

ABSTRACT OBJECTIVES Proliferation centers (PCs) are a characteristic finding in CLL/SLL lymph nodes, and their presence and extent in this site are not currently felt to be related to clinical course. In contrast, detailed clinicopathologic analyses of bone marrow (BM) PCs have not been previously r...

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Bibliographic Details
Published in:Annals of diagnostic pathology 2016-12, Vol.25, p.15-19
Main Authors: Chang, Jason C., M.D, Harrington, Alexandra M., M.D, Olteanu, Horatiu, M.D., Ph.D, VanTuinen, Peter, Ph.D, Kroft, Steven H., M.D
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Bone Marrow - pathology
Bone marrow pattern
Cell Proliferation - physiology
Chronic lymphocytic leukemia
Female
Flow Cytometry - methods
Humans
Immunophenotyping
In Situ Hybridization, Fluorescence - methods
Leukemia, Lymphocytic, Chronic, B-Cell - pathology
Lymph Nodes - pathology
Lymphoma, B-Cell - diagnosis
Lymphoma, B-Cell - pathology
Male
Middle Aged
Pathology
Proliferation center
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Summary:ABSTRACT OBJECTIVES Proliferation centers (PCs) are a characteristic finding in CLL/SLL lymph nodes, and their presence and extent in this site are not currently felt to be related to clinical course. In contrast, detailed clinicopathologic analyses of bone marrow (BM) PCs have not been previously reported. METHODS PCs in 88 CLL/SLL BMs from 45 patients (pts) were graded (0–4) and were correlated with other morphologic, immunophenotypic, cytogenetic, and laboratory features. RESULTS PCs were present in 69 BMs (78%) from 32 pts. (71%), and were distinct/prominent (grades 2–4) in 21 pts. (47%), with the latter more commonly found in follow-up BMs (1/7 diagnostic BMs versus 49/81 follow-up BMs; P = .04). When present, PCs were most commonly graded as distinct nodules easily visible on 10x. No relationships were identified between PCs and any CBC parameter, serum LDH or IgG levels, degree or pattern of BM involvement, blood morphology, CD38 and FMC7 expression by flow cytometry, or FISH results, when the first encountered BM was considered for each patient. CONCLUSIONS This represents the first detailed analysis of PCs in CLL/SLL BMs. In our tertiary center, PCs were seen frequently, in approximately ¾ of cases. There were no statistical associations identified between PCs and cytogenetic, immunophenotypic, or other laboratory and morphologic findings.
ISSN:1092-9134
1532-8198
DOI:10.1016/j.anndiagpath.2016.07.011