Lymph node biopsy in chronic lymphocytic leukemia: prognostic significance of histopathological, morphometry and immunohistological findings

The morphological patterns of 20 lymph node biopsies from well differentiated lymphocytic proliferation (CLL and DWDL) were studied using conventional morphology and morphometric technics; immunohistochemistry analysis were performed in 12 cases. Four subtypes of histological patterns were described according to the number and the distribution of large lymphoïd cells. These aspects were compared to the nuclear area distribution curve and clinical staging. Patients with numerous large lymphoïd cells had a right deviation of the curve and were clinically stage C. In stage B patients, the analysis of nuclear area distribution curve individualized patients with a worse prognosis. In 12 cases immunohistochemical technics were applied to determine SmIg, B cell differentiation antigens (CD19, CD20, CD21, BL14, FmC7) and T cells subsets (CD2, CD3, CD4, CD8) the quantification of the various T cell subsets showed that CD3, CD4, positive T cell were lower in advanced stages of CLL.