A novel variant of B-lymphoid leukemia expressing kappa/lambda light chains.
We studied a patient with an indolent leukemia which behaved similarly to chronic lymphocytic leukemia (CLL). Leukemic cells, however, showed larger cell diameters and lower nuclear/cytoplasmic ratios than typical CLL cells, and contained numerous cytoplasmic vacuoles. The cells also demonstrated some morphologic characteristics of hairy cell leukemia. Furthermore, flow-cytometric analysis demonstrated a distinct population of kappa/lambda double-positive tumor cells, as well as kappa single and lambda single populations. Southern blot analysis confirmed rearranged bands for both light chains with a monoclonal heavy chain rearrangement. Despite a decision not to treat this asymptomatic patient, disease progression was not observed. This case may represent a unique variant of B lymphoid leukemia. Possible mechanisms of abnormal light chain expression are discussed.
Fourth Department of Internal Medicine, Tokai University Hospital, Bohseidai, Isehara, Kanagawa, Japan.
H
H
Kawada
R
R
Fukuda
M
M
Yoshida
T
T
Kawakami
T
T
Kawada
H
H
Miyachi
Y
Y
Tsutsumi
S
S
Yonekura
Y
Y
Ichikawa
T
T
Hotta
D000368:Aged; D015703:Antigens, CD / Q000276:immunology; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000096:biosynthesis / Q000276:immunology*; D007146:Immunoglobulin lambda-Chains / Q000096:biosynthesis / Q000276:immunology*; D016130:Immunophenotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000145:classification / Q000276:immunology* / Q000473:pathology; D008297:Male
D015703:Antigens, CD; D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains