title: Precursor B-cell lymphoblastic leukemia with surface immunoglobulin light chain expression in 2 chinese patients.
abstract: BACKGROUND
  Precursor B-cell acute lymphocytic leukemia (ALL) with surface immunoglobulin light chain expression is a rare disease entity. The differential diagnosis is difficult but critical for disease management.
  
  
  OBJECTIVE
  We report 2 cases (1 adult and 1 infant) of precursor B-cell ALL who presented at diagnosis with surface immunoglobulin light chain expression revealed by flow cytometric immunophenotyping and discuss its clinical significance.
  
  
  METHODS
  The 2 patients presented with nonspecific symptoms such as fever, pallor, fatigue or lymphadenopathy. Flow cytometric immunophenotyping showed that both patients expressed CD34/CD19/CD10/CD22/CD9/HLA-DR/CD38/CD123/CD13 (partial) and had unexpected single λ light chain expression. Cytogenetic analysis revealed t(9;22)(q34;q11) in the adult patient and normal karyotype in the infant. Both cases were diagnosed and managed as precursor B-ALL, and the patients showed good response to treatment regimens.
  
  
  CONCLUSIONS
  We describe 2 cases of precursor B-ALL with unexpected surface light chain expression. The exceedingly rare immunophenotypes have diagnostic implication for immunophenotyping of this malignancy. Treatment regimens for precursor B-cell ALL are suitable for such cases.
authors.affiliation: Hematology Department, Henan Provincial People's Hospital, The People's Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Yanhui
authors.initials: Y
authors.lastname: Liu
authors.forename: Yaping
authors.initials: Y
authors.lastname: Zhai
authors.forename: Yin
authors.initials: Y
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Cheng
authors.forename: Yulong
authors.initials: Y
authors.lastname: Li
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000096:biosynthesis; D044466:Asian People; D002681:China; D005260:Female; D005434:Flow Cytometry; D015973:Gene Expression Regulation, Leukemic; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D007146:Immunoglobulin lambda-Chains / Q000096:biosynthesis*; D007223:Infant; D008297:Male; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood* / Q000473:pathology / Q000628:therapy
chemical_list: D015703:Antigens, CD; D006684:HLA-DR Antigens; D007146:Immunoglobulin lambda-Chains