B-cell prolymphocytic leukemia: an enduring bona fide entity.

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• B-cell prolymphocytic leukemia (B-PLL) was recognized in the WHO-HAEM4 classification.
• The de novo presentation of B-PLL has been removed from the upcoming WHO-HAEM5 classification.
• This change necessitates careful evaluation of B-PLL cases.

Observation:

• A 65-year-old male presented with leukocytosis and fatigue.
• Imaging revealed no organomegaly.
• Bone marrow examination identified a prolymphocytoid population constituting 78% of marrow elements.

Findings:

• After excluding other hematolymphoid neoplasms, the case was diagnosed as de novo B-cell prolymphocytic leukemia.
• The diagnosis was supported by clinical parameters and ancillary methods.
• This case underscores the importance of recognizing B-PLL despite classification changes.

Implications:

• This case emphasizes the continued clinical relevance of B-cell prolymphocytic leukemia.
• It highlights the need for accurate diagnosis and classification of hematolymphoid neoplasms.
• Further research may be warranted to clarify the status of de novo B-PLL in future classifications.