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Figure 14.20 PBF in chronic lymphocytic leukaemia (CLL). There is large excess of mature and small differentiated lymphocytes and some
degenerated forms appearing as bare smudged nuclei.
SECTION II

III. LYMPH NODE BIOPSY. Cases with lymphadeno- 2. Positive for B-cell markers e.g. typically CD5 positive;
pathy at presentation show replacement of the lymph other pan-B cell markers are CD19, CD20, CD23, surface
node by diffuse proliferation of well-differentiated, immunoglobulins of various classes, monoclonal light
mature, small and uniform lymphocytes without any chains (λ or κ type).
cytologic atypia or significant mitoses (Fig. 14.21,B). These 3. Serum immunoglobulin levels are generally reduced.
cells are of monoclonal B-cell origin having immunologic 4. Coombs’ test is positive in 20% cases.
features of mantle zone B-cells. 5. Cytogenetic abnormalities, most commonly trisomy 12
IV. OTHER INVESTIGATIONS. These include the seen in about 25% cases.
following:
1. Erythrocyte rosette test with mouse red cells is positive Treatment and Prognosis
in more than 95% of cases indicating that CLL is a Unlike other leukaemias, none of the available drugs and
monoclonal B cell neoplasm. radiation therapy are capable of eradicating CLL and induce

Haematology and Lymphoreticular Tissues

Figure 14.21 Prototypes of non-Hodgkin’s
lymphoma—small lymphocytic lymphoma SLL/
CLL (B) and follicular lymphoma (C) contrasted
with structure of normal lymph node (A).