Pathology
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Atlas of Bone Marrow pathology
Mojmir Moulis, Josef Feit et al.
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+ Introduction
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+ Technical notes
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+ Support
+ Support
+ Bone Marrow Pathology
+ Bone Marrow Examination
+ Bone Marrow Examination
+ Histological evaluation of the trephine biopsy core
+ Normal bone marrow
+ Bone Marrow Cellularity
+ Hematopoiesis
+ Non-tumorous Lesions of Bone Marrow
+ Reactive Hematopoietic Changes
+ Erythroid hyperplasia
+ Myeloid Hyperplasia
+ Eosinophilia
+ Increased Number of Megakaryocytes
+ Bone Marrow Hypoplasia and Aplasia
+ Aplastic Anemia
+ Pure red cell aplasia
+ Agranulocytosis
+ Amegakaryocytic thrombocytopenia
+ Anemias
+ Posthemorrhagic anemias
+ Acute Posthemorrhagic Anemia
+ Chronic Posthemorrhagic Anemia
+ Megaloblastic Anemia
+ Sideropenic Anemia
+ Chronic Kidney Disease Anemia
+ Anemias of Chronic Disorders
+ Hemolytic Anemias
+ Other anemias
+ Stromal Reaction and Bone Marrow Inflammation
+ Reactive lymphocytosis, benign lymphocytic aggregates
+ Reactive Plasmacytosis
+ Granulomas
+ Hemophagocytic Syndrome
+ Storage Diseases (Thesaurismosis)
+ Gaucher's Disease
+ Niemann–Pick Disease
+ Bone marrow tumorus diseases
+ Myelodysplastic Syndrome (MDS)
+ Refractory Cytopenia with Unilineage Dysplasia (RCUD)
+ Refractory Anemia with Ringed Sideroblasts (RARS)
+ Refractory Cytopenia with Multilineage Dysplasia (RCMD)
+ Refractory Anemia with Excess Blats (RAEB)
+ MDS with Isolated 5q Deletion (5q-syndrome)
+ Myelodysplastic Syndrome Unclassified (MDS NOS)
+ Myeloproliferative neoplasms
+ Polycythemia Vera (PV)
+ Essential Thrombocythemia (ET)
+ Primary Myelofibrosis (PMF)
+ Chronic Myeloid Leukemia (CML)
+ Chronic Neutrophilic Leukemia (CNL)
+ Chronic Eosinophilic Leukemia (CEL)
+ Mastocytosis
+ MPN unclassifiable (MPN-U)
+ Myelodysplastic-myeloproliferative diseases (MDS/MPD)
+ Chronic Myelomonocytic Leukemia (CMML)
+ Atypical Chronic Myeloid Leukemia (aCML)
+ Juvenile Myelomonocytic Leukemia (JMML)
+ Myelodysplastic-Myeloproliferative Diseases Unclassifiable
+ Acute Myeloid Leukemia (AML)
+ Lymphoproliferative Disorders
+ Acute Lymphoblastic Leukemia (ALL)
+ Chronic Lymphocytic Leukemia (CLL)
+ Prolymphocytic Leukemia (PLL)
+ Hairy cell leukemia (HCL)
+ Plasma Cell Neoplasms
+ Plasma Cell (Multiple) Myeloma
+ Solitary Plasmocytoma
+ Monoclonal Gammapathy of Undetermined Significance (MGUS)
+ Other Lymphoproliferative Diseases
+ Histiocytoses
+ Histiocytosis X (Langerhans Cell Histiocytosis)
+ Letterer-Siwe Histiocytosis
+ Hand-Schüller-Christian Histiocytosis
+ Eosinophilic Granuloma
+ Histiocytic Sarcoma
+ Metastatic Infiltration of the Bone Marrow
+ Posttheraupetic a Posttransplant Hematopoietic Changes
+ Posttheraupetic Hematopoietic Changes
+ Restitution of Hematopoiesis
+ Persistent Alterations of Hematopoiesis.
+ Posttransplant Alterations of Hematopoiesis
+ Pathology of the Bone
+ Other Disorders
Chronic Lymphocytic Leukemia (CLL)
Pathogenesis

The offending cells are mature naive B lymphocytes.

Clinical signs
  • age: affects mostly elderly patients (median is approx. 65 years of age)
  • at first asymptomatic
  • anemia
  • thrombocytopenia
  • leukocytosis with lymphocytosis
  • hepatosplenomegaly
  • lymphadenopathy and other
  • prognosis:
    • low malignant disease
    • indolent progression
    • incurable
    • median survival time is 7 let
    • may transform into an agressive malignant lymphoma (Richter's syndrome)
Histology

Same as small lymphocytic lymphoma — small cells with the appearance of mature lymphocytes, with round nuclei, dense chromatin, and inconspicuous nucleoli, a narrow rim of basophilic cytoplasm. Proliferation centres also contain prolymphocytes and paraimunoblasts.

Imunophenotype: B lineage (CD20+ a CD79a+), CD5+, CD23+.

Pictures

Chronic lymphocytic leukemia, bone marrow: Chronic lymphatic leukemia, bone marrow, HE 100x (73238) Chronic lymphatic leukemia, bone marrow, PAS 100x (73239)

A different case: Chronic lymphatic leukemia B, HE 100x (73355) Chronic lymphatic leukemia B, PAS 100x (73356) Chronic lymphatic leukemia B, CD20 100x (73352) Chronic lymphatic leukemia B, CD5 100x (73354) Chronic lymphatic leukemia B, CD23 100x (73353)