Merdin Alparslan, Yıldız Jale, Dal Mehmet Sinan, Çakar Merih Kızıl, Batgi Hikmetullah, Tekgündüz Emre, Onursever Aykut, Altuntaş Fevzi
Hematology Clinic and Bone Marrow Transplantation Unit, and Research Hospital, Ankara, Turkey.
Pathology Clinic, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
Hematol Rep. 2017 Mar 22;9(1):6995. doi: 10.4081/hr.2017.6995. eCollection 2017 Feb 23.
Prolymhocytic leukemia (PLL) is a rare subtype of lymphocytic leukemias and its cells are immature lymphocytes. It is divided into 2 subgroups: T-PLL and B-PLL according to the lymphocytic origin of the cells. Discriminating B-PLL from other diseases with clinically-similar features is important because of the different treatment approaches and follow-up programs. Hereby, we report a 80-year-old woman presenting with fatigue, leucocytosis and mild anemia. Her peripheral blood smear evaluation revealed 85% prolymphocytes with moderately condensed nuclear chromatin, prominent nucleoli, and a faintly basophilic cytoplasm. Positron emission tomography-computed tomography showed mediastinal lymph nodes with cervical lymph nodes. There was no pathological FDG involvement in the spleen. Bone marrow aspiration smear exhibit atypical wide lymphocytes with prominent nucleoli and abundant agranular cytoplasm. Flow cytometry analysis revealed positive CD5, CD19, CD20, CD22, CD11c, CD25, CD79a and CD79b. Fluorescence hybridization technique analysis reveals no t(11;14). Bone marrow biopsy revealed interstitially distributed atypical cells with wide nucleus and prominent nucleolus.
幼淋巴细胞白血病（PLL）是淋巴细胞白血病的一种罕见亚型，其细胞为未成熟淋巴细胞。根据细胞的淋巴细胞起源，它可分为两个亚组：T-PLL和B-PLL。由于治疗方法和随访方案不同，鉴别B-PLL与其他具有临床相似特征的疾病很重要。在此，我们报告一名80岁女性，表现为疲劳、白细胞增多和轻度贫血。她的外周血涂片评估显示85%为幼淋巴细胞，核染色质中度浓缩，核仁突出，胞质轻度嗜碱性。正电子发射断层扫描-计算机断层扫描显示纵隔淋巴结及颈部淋巴结。脾脏无病理性FDG摄取。骨髓穿刺涂片可见具有突出核仁及丰富无颗粒胞质的非典型宽大淋巴细胞。流式细胞术分析显示CD5、CD19、CD20、CD22、CD11c、CD25、CD79a和CD79b呈阳性。荧光杂交技术分析显示无t(11;14)。骨髓活检显示间质分布的非典型细胞，核宽大，核仁突出。
