Ghodke Kiran Ashok, Patkar Nikhil V, Subramanian P G, Gujral Sumeet, Kadam Pratibha Aamre, Tembhare Prashant R
Department of Pathology, Hematopathology Laboratory, Tata Memorial Centre, Mumbai, Maharashtra, India.
Department of Cancer Cytogenetics, Tata Memorial Centre, Mumbai, Maharashtra, India.
Indian J Pathol Microbiol. 2017 Jan-Mar;60(1):84-86. doi: 10.4103/0377-4929.200019.
Chronic lymphocytic leukemia (CLL) is a common, immunophenotypically well-defined mature B-cell neoplasm. Demonstration of more than 5000/μL CD5+ B-cell population with co-expression of CD23, weak expression of CD20, and one type of immunoglobin light chain (either kappa or lambda) is necessary for the diagnosis of CLL. However, CLL with two populations of B-cells expressing both kappa as well as lambda (biclonal) light chains are extremely rare and has not been reported from India. We report two cases of biclonal CLL presented with leukocytosis, typical morphological features, and distinct immunophenotype of CLL. These cases are also an example which suggests that careful attention to the morphology of the blood smear and the entire immunophenotype panel is a must and will aid the proper diagnosis as only light chain ratios can be misguiding.
慢性淋巴细胞白血病（CLL）是一种常见的、免疫表型明确的成熟B细胞肿瘤。诊断CLL需要证明存在超过5000/μL的CD5+B细胞群，同时伴有CD23共表达、CD20弱表达以及一种免疫球蛋白轻链（κ或λ）。然而，具有表达κ和λ（双克隆）两种轻链的B细胞群的CLL极为罕见，印度尚未有相关报道。我们报告了2例双克隆CLL病例，其表现为白细胞增多、典型的形态学特征以及CLL独特的免疫表型。这些病例还表明，必须仔细关注血涂片形态和整个免疫表型检测结果，这将有助于正确诊断，因为仅轻链比例可能会产生误导。
