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Follicular small lymphocytic lymphoma
K L Chang1, D A Arber, D Shibata
1Department of Pathology, City of Hope National Medical Center, Duarte, CA 91010-0269.
The American Journal of Surgical Pathology
|October 1, 1994
Summary
This study identifies a new form of small lymphocytic lymphoma (SLL), termed follicular SLL (FSLL). FSLL exhibits distinct follicular patterns and bcl-2 rearrangements, suggesting a closer link to follicular lymphoma than classic SLL.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Small lymphocytic lymphoma (SLL) is a type of non-Hodgkin lymphoma.
- Distinct morphologic variants of SLL may have different clinical behaviors and prognoses.
Purpose of the Study:
- To describe a distinct morphologic form of SLL, termed follicular SLL (FSLL).
- To investigate the immunophenotypic and molecular characteristics of FSLL.
- To correlate findings with clinical outcomes.
Main Methods:
- Morphologic analysis of nine FSLL specimens.
- Immunohistochemical staining for B cell phenotype and bcl-2 protein.
- Polymerase chain reaction (PCR) for bcl-2 major breakpoint region rearrangements.
- Review of clinical information for eight patients.
Main Results:
- FSLL showed a true follicular pattern with cytologic features identical to SLL.
- All available specimens were B cell positive and bcl-2 protein positive.
- bcl-2 rearrangements were detected in 4 of 5 cases.
- Patients presented with lymph node disease, some with extranodal involvement.
- Prognosis varied, with some patients experiencing relapse, chemotherapy resistance, or death from disease.
Conclusions:
- Follicular SLL (FSLL) represents a distinct morphologic entity.
- The presence of bcl-2 rearrangements suggests a pathogenesis related to follicular lymphoma.
- FSLL may have a different clinical behavior compared to classic SLL.