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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
PubMed
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.

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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.

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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.