Kroft S H, Dawson D B, McKenna R W
Dept of Pathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9073, USA.
Am J Clin Pathol. 2001 Mar;115(3):385-95. doi: 10.1309/F5WE-K2T8-BT9D-Q56D.
We studied 7 cases of large cell transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) immunophenotyped by multiparameter flow cytometry. The 6 women and 1 man ranged in age from 45 to 91 years. All had previous or concurrent evidence of CLL/SLL. Morphologic features and sites of involvement of the diffuse large B-cell lymphoma (DLBCL) were heterogeneous; 2 cases had paraimmunoblastic morphologic features. Six DLBCLs had an immunophenotype consistent with CLL: CD19+, CD5+, CD23+, and FMC7 negative (3 cases) or very dim (2 cases); 1 case was not studied for FMC7. CD20 was dim in 3 of these, moderate to bright in 2, and variable in 1. Surface immunoglobulin was dim in 2 cases and moderate or bright in 4. Five of 6 expressed CD38. Comparison with the immunophenotypes of the previous or coexistent CLL/SLL (4 of 6 cases) revealed minor modulations in antigen expression but no major alterations. The seventh DLBCL lacked CD5 expression, but otherwise had immunophenotypic features similar to CLL. These findings indicate that DLBCL arising in CLL/SLL tends to retain a CLL immunophenotype, in contrast with de novo CD5+ large cell lymphomas that uncommonly express such a phenotype.
我们研究了7例经多参数流式细胞术进行免疫表型分析的慢性淋巴细胞白血病/小淋巴细胞淋巴瘤（CLL/SLL）大细胞转化病例。6名女性和1名男性，年龄在45至91岁之间。所有患者既往或同时存在CLL/SLL证据。弥漫性大B细胞淋巴瘤（DLBCL）的形态学特征和受累部位各不相同；2例具有副免疫母细胞形态学特征。6例DLBCL的免疫表型与CLL一致：CD19+、CD5+、CD23+，FMC7阴性（3例）或非常弱（2例）；1例未检测FMC7。其中3例CD20弱表达，2例中度至强表达，1例表达情况不一。2例表面免疫球蛋白弱表达，4例中度或强表达。6例中有5例表达CD38。与既往或并存的CLL/SLL（6例中的4例）的免疫表型比较显示，抗原表达有轻微调节，但无重大改变。第7例DLBCL缺乏CD5表达，但其他免疫表型特征与CLL相似。这些发现表明，CLL/SLL中出现的DLBCL倾向于保留CLL免疫表型，这与很少表达这种表型的原发性CD5+大细胞淋巴瘤形成对比。
