背景:慢性淋巴细胞白血病(CLL)是成人中最常见的白血病。染色体异常t(14;18)(q32;q21)通常与滤泡中心细胞起源的肿瘤相关。然而,在罕见的CLL病例中也报告了t(14;18)。
目的:我们描述了临床病理,免疫表型,常规,和两个罕见病例的分子细胞遗传学特征在形态学和免疫学上被证明是CLL,其中t(14;18)被发现是唯一的细胞遗传学异常。
方法:形态学,对外周血和/或骨髓样本进行了流式细胞仪分析和分子细胞遗传学分析.
结果:细胞形态学,这些细胞是小的成熟淋巴细胞,没有任何具有滤泡性淋巴瘤(FL)特征的发现,例如核凹陷或裂开.免疫学发现是典型CLL的特征,无CD10表达。细胞遗传学研究显示两例CLL携带t(14;18)(q32;q21)。
结论:我们得出结论,t(14;18)的CLL很少见,应与FL区分开,因为两种疾病之间的治疗方法高度不同。使用免疫球蛋白重链基因(IGH)探针在可疑CLL患者的检查中很重要,并建议IGH探针应常规用于所有CLL荧光原位杂交(FISH)组中。
BACKGROUND: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. The chromosomal abnormality t(14;18)(q32;q21) is most commonly associated with neoplasms of a follicular center cell origin. However, t(14;18) has also been reported in rare cases of CLL.
OBJECTIVE: We describe the clinicopathologic, immunophenotypic, conventional, and molecular cytogenetic features of two rare cases proven to be CLL morphologically and immunologically in which t(14;18) was found as the sole cytogenetic abnormality.
METHODS: Morphologic, flow cytometric analysis and molecular cytogenetic of peripheral blood and/or bone marrow samples were analyzed.
RESULTS: Cytomorphologically, the cells were small mature lymphocytes without any findings that had characteristics of follicular lymphoma (FL) such as indented or clefted nuclei. Immunologic findings were characteristic of typical CLL without expression of CD10. A cytogenetic study revealed the two cases of CLL carrying t(14;18)(q32;q21).
CONCLUSIONS: We concluded that CLL with t(14;18) is rare and should be differentiated from FL as the therapy is highly diverse between both diseases. Using immunoglobulin heavy chain gene (IGH) probes are important in the workup of patients with suspected CLL and suggest that the IGH probe should be used routinely in all CLL fluorescence in situ hybridization (FISH) panels.