After a course of treatment, the patient showed refractory pleural effusion, in which prolymphocyte
count remained less than 5% and there was no evidence of large cell transformation.
leukemia (B-PLL) is a somewhat ill-defined, uncommon entity characterized by marked peripheral lymphocytosis composed of more than 55% prolymphocytes
(large lymphocytes with a prominent central nucleolus).
Bone marrow aspirate smear revealed lymphocyte dominance at the rate of 60% without increased prolymphocytes
T-cell prolymphocytic leukemia (T-PLL) is a rare and aggressive post-thymic malignancy that is characterized by the proliferation of small- to medium-sized prolymphocytes
Nuclear staining with LEF1 is positive in lymphoma cells of SLL; the nuclear staining is stronger in prolymphocytes
and in the transformed large lymphoma cells of Richter syndrome (not shown) (original magnification X500).
In the late 1990s, various groups reported a correlation between clinical outcome and Rai stage with respect to the morphology of CLL lymphocytes, the pattern ofbone marrowinfiltration, lymphocyte doubling time, and the percentage of prolymphocytes
More than 55% prolymphocytes
in the blood suggests a diagnosis of B-cell prolymphocytic leukemia (B-PLL) (7).
For CLL samples, the CBC report needs to include both the lymphocyte count and lymphocyte morphologic features, such as the presence of prolymphocytes
, atypical lymphocytes, or smudge cells.
By definition, prolymphocytes
must exceed 55%, and cases with 11-54% prolymphocytes
are designated CLL/PLL [1,2].
A diagnosis of full blown PLL is usually associated with more than 55% circulating prolymphocytes
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is a neoplasm of small, round, mature B lymphocytes, often admixed with prolymphocytes