title: Diagnostic problems among chronic lymphocytic leukemia and other indolent B-cell leukemias in a Japanese population.
abstract: OBJECTIVE
  Japanese chronic lymphocytic leukemia (CLL) provides a diagnostic dilemma due to the low incidence and the heterogeneity shown in its morphology and immunophenotype. We clarified the diagnostic problems in Japanese CLL through our retrospective observation.
  
  
  METHODS
  Between 2006 and 2011, we found a total of 48 cases with CLL and other indolent B-cell leukemias. We made a diagnosis of true CLL based on clinical, laboratory, immunophenotypic and cytogenetic data.
  
  
  RESULTS
  Among the 48 cases, only 28 cases (58.3%) were diagnosed with true CLL. Morphologic evaluation using a forced-air dried preparation alone is not helpful to distinguish CLL from other indolent B-cell leukemias, including hairy cell leukemia, mantle cell lymphoma, lymphoplasmacytic lymphoma, and splenic marginal zone lymphoma. CLL immunophenotypic score should be more strictly applied in Japan than in Western countries.
  
  
  CONCLUSIONS
  Fluorescence in situ hybridization for CCND1/IGH, the presence of leukocytosis and lymphadenopathy at diagnosis, and the morphological evaluation using naturally air dried preparations are important clues to make a correct diagnosis of Japanese CLL.
authors.affiliation: Department of Hematology, Juntendo University School of Medicine, Japan. yisobe@juntendo.ac.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Isobe
authors.forename: Junichi
authors.initials: J
authors.lastname: Tomomatsu
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tsukune
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsukada
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Norio
authors.initials: N
authors.lastname: Komatsu
mesh_terms: D044466:Asian People; D018956:CD5 Antigens / Q000378:metabolism; D020732:Cytogenetic Analysis; D006801:Humans; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D007564:Japan; D015448:Leukemia, B-Cell / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology; D007943:Leukemia, Hairy Cell / Q000175:diagnosis; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology; D054403:Leukemia, Prolymphocytic, B-Cell / Q000175:diagnosis; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis; D008224:Lymphoma, Follicular / Q000175:diagnosis; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D012189:Retrospective Studies
chemical_list: D018956:CD5 Antigens; C529133:IGH-CCND1 fusion protein, human; D015514:Oncogene Proteins, Fusion