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Theml, Color Atlas of Hematology - part 5

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Một lymphadenoma mãn tính, hoặc bệnh bạch cầu lymphocytic mãn tính, đôi khi có thể được chẩn đoán lâm sàng một cách chắc chắn một số. Một ví dụ là trường hợp của một bệnh nhân (thường là tuổi trở lên) với các hạch bạch huyết rõ ràng mở rộng | 74 Abnormalities of the White Cell Series Chronic Lymphocytic Leukemia CLL and Related Diseases A chronic lymphadenoma or chronic lymphocytic leukemia can sometimes be clinically diagnosed with some certainty. An example is the case of a patient usually older with clearly enlarged lymph nodes and significant lymphocytosis in 60 of the cases this is greater than 20 000 p.l and in 20 of the cases it is greater than 100 000 p.l in the absence of symptoms that point to a reactive disorder. The lymphoma cells are relatively small and the nuclear chromatin is coarse and dense. The narrow layer of slightly basophilic cytoplasm does not contain granules. Shadows around the nucleus are an artifact produced by chromatin fragmentation during preparation Gumprecht s nuclear shadow . In order to confirm the diagnosis the B-cell markers on circulating lymphocytes should be characterized to show that the cells are indeed monoclonal. The transformed lymphocytes are dispersed at varying cell densities throughout the bone marrow and the lymph nodes. A slowly progressing hypogammaglobulinemia is another important indicator of a B-cell maturation disorder. Transition to a diffuse large-cell B-lymphoma Richter syndrome is rare B-prolymphocytic leukemia B-PLL displays unique symptoms. At least 55 of the lymphocytes in circulating blood have large central vacuoles. When 15-55 of the cells are prolymphocytes the diagnosis of atypical CLL or transitional CLL PLL is confirmed. In some CLL-like diseases the layer of cytoplasm is slightly wider. B-CLL was defined as lym-phoplasmacytoid immunocytoma in the Kiel classification. According to the WHO classification it is a B-CLL variation compare this with lympho-plasmacytic leukemia p. 78 . CLL of the T-lymphocytes is rare. The cells show nuclei with either invaginations or well-defined nucleoli T-prolym-phocytic leukemia . The leukemic phase of cutaneous T-cell lymphoma CTCL is known as Sézary syndrome. The cell elements in this syndrome and .