title: Chronic lymphocytic leukemia/small lymphocytic lymphoma: another neoplasm related to the B-cell follicle?
abstract: Although there has been increased attention paid to the critical nature of nodal involvement in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), the B-cell compartment it is most closely related to and its relationship to the follicle remain uncertain. A clinicopathologic investigation of 60 extramedullary biopsies of LEF1+ CLL/SLL, including 29 cases with perifollicular/follicular (PF/F) growth, was therefore performed. A subset of PF/F cases demonstrated inner mantle zone preservation or intra-mantle zone growth. All PF/F and 16/31 other cases contained CD21+ follicular dendritic cells. No cytogenetic, IGHV mutational or gene usage differences were seen between PF/F and diffuse cases. PF/F cases were more often kappa positive (p<0.03) and had fewer involved nodal sites (p=0.0004). These findings suggest that at least a subset of bona fide CLL/SLL is related to the follicle, most likely the outer mantle zone, and that at least a subset of the diffuse cases may represent "later" disease.
authors: a University of Pittsburgh School of Medicine , Pittsburgh , PA , USA.
authors: Bevan
authors: B
authors: Tandon
authors: a University of Pittsburgh School of Medicine , Pittsburgh , PA , USA.
authors: Steven H
authors: SH
authors: Swerdlow
authors: b Massachusetts General Hospital , Boston , MA , USA.
authors: Robert P
authors: RP
authors: Hasserjian
authors: a University of Pittsburgh School of Medicine , Pittsburgh , PA , USA.
authors: Urvashi
authors: U
authors: Surti
authors: a University of Pittsburgh School of Medicine , Pittsburgh , PA , USA.
authors: Sarah E
authors: SE
authors: Gibson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001402:B-Lymphocytes / Q000378:metabolism / Q000473:pathology*; D015415:Biomarkers / Q000378:metabolism; D002869:Chromosome Aberrations; D003713:Dendritic Cells; D003937:Diagnosis, Differential; D005260:Female; D018858:Germinal Center / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007150:Immunohistochemistry; D016130:Immunophenotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging
chemical_list: D015415:Biomarkers; D007143:Immunoglobulin Heavy Chains
keywords: B-cell follicle; chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL); follicular dendritic cells