Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc
Journal website https://www.thejh.org

Case Report

Volume 12, Number 2, April 2023, pages 82-86

De-Novo B-Cell Prolymphocytic Leukemia

Figures

Figure 1.
Figure 1. A broad differential diagnosis for B-PLL. B-PLL: B-cell prolymphocytic leukemia; CLL: chronic lymphocytic leukemia; MCL: mantle cell lymphoma; HCL-v: hairy cell leukemia variant; SMZL: splenic marginal zone lymphoma; SDRP: splenic diffuse red pulp; FL: follicular lymphoma; WBC: white blood cell; Avg: average; LC: light chain.
Figure 2.
Figure 2. Core biopsy showing hypercellular marrow for age of patient (about 90%), with ill-defined aggregates of lymphocytes (yellow circled areas). Note the lack of “fried-egg” appearance which is seen with hairy cell leukemia.
Figure 3.
Figure 3. Pax 5 immunohistochemical stain showing increased B cells (brown staining). Note the lack of intrasinusoidal distribution of B cells typically seen in splenic diffuse red pulp lymphoma.
Figure 4.
Figure 4. Blood smear showing a normal small lymphocyte near the upper left-hand corner (blue arrow), and normal monocytes near the lower right corner (green arrow) for comparison. The rest of the cells are B-PLL cells which are as big if not bigger than monocytes. B-PLL: B-cell prolymphocytic leukemia.