CD5- B-cell lymphoproliferative disorders presenting in blood and bone marrow. A clinicopathologic study of 40 patients.
We studied 40 patients with CD5- B-cell lymphoproliferative disorders (B-LPDs) presenting in blood or bone marrow and 28 control patients with CD5+ B-cell chronic lymphocytic leukemia (CLL). Fifteen study patients had morphologic features typical of CLL. The 15 patients with CD5- CLL were older and had lower absolute lymphocyte counts and more advanced-stage disease at diagnosis than controls. Ten study patients had morphologic features suggesting mantle cell lymphoma (MCL); 3 were later given a diagnosis of MCL based on lymph node biopsy results. The 10 patients with CD5- MCL were older and at a more advanced stage than CLL control patients. The remaining 15 study patients were given the following diagnoses: circulating non-Hodgkin lymphoma, 5; splenic lymphoma with villous lymphocytes, 5; lymphoplasmacytoid lymphoma, 3; and CLL/pro-lymphocytic leukemia, 2. For the patients with CD5- B-LPDs with morphologic features and manifestations resembling CLL, we prefer the term CD5- CLL variant because of clinical and immunophenotypic differences. Patients with CD5- B-LPDs with atypical nuclear morphologic features may represent the leukemic phase of MCL. Since CD23 is expressed in most patients with CD5- B-LPD, its use in subclassifying these disorders seems limited.
Shapiro
J L
JL
Department of Pathology, Cleveland Clinic Foundation, Ohio 44195, USA.
Miller
M L
ML
Pohlman
B
B
Mascha
E
E
Fishleder
A J
AJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001402:B-Lymphocytes / Q000276:immunology / Q000473:pathology*; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology*; D018956:CD5 Antigens / Q000032:analysis*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D018655:Lymphocyte Count; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000473:pathology; D008232:Lymphoproliferative Disorders / Q000097:blood* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D017455:Receptors, IgE / Q000032:analysis
D018956:CD5 Antigens; D017455:Receptors, IgE