Chronic lymphocytic leukaemia: a review of the immuno-architecture

Immunophenotyping of B cell chronic lymphocytic leukaemia (B-CLL) is usually performed by flow cytometry on cell suspensions obtained from peripheral blood, bone marrow or biopsied tissue. Immunohistochemical analysis on routine sections is less commonly performed; however, this approach allows the pathologist and the researcher to appreciate the immuno-architecture of the involved tissues and to gain insight into some of the events that influence the biology of the disease. In this review the authors focus on the following issues: immuno-architecture of the proliferation centres, expression of CD23, MUM1/IRF-4 and cyclin D1, tyrosine phosphorylation and detection of the ZAP-70 kinase. Whenever possible, an attempt is made to interpret the immunohistochemical findings from a functional point of view.