Morphological features:
- Small, mature atypical lymphoid cells
- Extremely high nuclear-cytoplasmic ratio
- No obvious nucleoli
- Smudge cells
0 x
0 x
0 x
0 x
Other features to look out for:
- Spherocytes – concommitant AIHA
- Thrombocytopaenia – concommitant ITP
- Prolymphocytes – prolymphocyte percentage of >55% is suggestive of B-PLL rather than CLL.
0 x
0 x
0 x
0 x
Differential diagnosis:
- Mantle cell lymphoma
- Marginal zone lymphoma
- Follicular llymphoma
Further investigations
- Peripheral blood immunophenotyping
- CD5 +
- SmIg weak
- CD23 +
- CD22 weak
- FMC7 –
- CD19 –
- Consider FISH for t(11;14) to exclude mantle cell lymphoma if the immunophenotype is not suggestive of CLL (the Marsden score can be used to determine this).
- Marsden score for CLL: >3 is suggestive of CLL.
| Marker | Score 1 | Score 0 |
|---|---|---|
| SmIg | Weak | Strong |
| CD5 | Positive | Negative |
| CD23 | Positive | Negative |
| FMC7 (CD20 can be considered a substitute) | Negative (Negative) | Positive (Weak) |
| CD22 or CD79b | Weak | Strong |
There is nothing to look at?
Thanks for highlighting. We are still in the middle of adding content.
Thank you this is so useful especially with the bone marrow aspirate and trephine
Glad you found it useful! Thank you for the feedback 🙂
excellent content.
more labelling in slides would be helpful