Hsi E D, Hoeltge G, Tubbs R R
Department of Clinical Pathology, Cleveland Clinic Foundation, OH 44195, USA.
Am J Clin Pathol. 2000 Jun;113(6):798-804. doi: 10.1309/V8AN-A2XP-7TDV-HR0T.
Chronic lymphocytic leukemia (CLL) is well characterized clinically and immunophenotypically. Demonstration of a monotypic CD19+, CD5+ B-cell population is central to the diagnosis. We report 2 cases of biclonal CLL. Two elderly men were encountered with an absolute lymphocytosis consisting of the typical CD5+, CD19+, CD23+ B-cell population seen in CLL; however, immunoglobulin light chain restriction by flow cytometry was not apparent as B cells expressed kappa or lambda light chains without a clear monotypic population. Molecular genetic analysis of flow cytometry-sorted cells (kappa and lambda populations) revealed in both cases 2 monoclonal B-cell populations. The characterization of these cases and a review of the issues surrounding biclonal CLL are presented.
慢性淋巴细胞白血病（CLL）在临床和免疫表型方面具有明确特征。单型CD19 +、CD5 + B细胞群的证实是诊断的关键。我们报告2例双克隆性CLL。遇到两名老年男性，其绝对淋巴细胞增多症由CLL中典型的CD5 +、CD19 +、CD23 + B细胞群组成；然而，通过流式细胞术检测，免疫球蛋白轻链限制并不明显，因为B细胞表达κ或λ轻链，没有明显的单型群体。对流式细胞术分选的细胞（κ和λ群体）进行分子遗传学分析，在两例中均发现2个单克隆B细胞群体。本文介绍了这些病例的特征以及围绕双克隆性CLL问题的综述。
