Canadian Association of Pathologists - Case of the Month, May 2007
Diagnosis:
Chronic lymphocytic leukemia (CLL).
Microscopic description of blood film: The blood film shows increased numbers of small mature lymphocytes with 'closed' chromatin pattern ('soccer ball' appearance).
Flow cytometry: Clonal kappa light chain restricted CD5+ B-cells that are positive for CD23 and negative for FMC7 and CD38. Lack of CD38 expression has been reported to be associated with a favorable outcome in CLL; however, additional prognostic information can be obtained by FISH analysis.
Fluoresence in situ hybridization (F.I.S.H.): In younger patients with newly diagnosed CLL, additional prognostic information can be obtained by FISH analysis for abnormalities in 11q22.3 (ATM gene), 13q14, the centromere of chromosome 12, and 17p13.1 (p53 gene). Trisomy 12 is associated with poor outcome in CLL and is the most common chromosomal abnormality in CLL found in approximately one third of patients.
See "Appearance of CLL and other lymphoproliferative disorders in bone marrow biopsies"
References:
Clinical, immunophenotypic, and molecular profiling of trisomy 12 in chronic lymphocytic leukemia and comparison with other karyotypic subgroups defined by cytogenetic analysis.
Athanasiadou A, et al. Cancer Genet Cytogenet. 2006 Jul 15;168(2):109-19