Chronic lymphocytic leukemia pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Overview

Chronic lymphocytic leukemia arises from pre-follicular center B cells, that are normally involved in the process of human immunoglobulins production. Development of chronic lymphocytic leukemia is the result of multiple genetic mutations that promote both malignant leukemic proliferation and apoptotic resistance of mature B cells. Structural genetic mutations involved in the pathogenesis of chronic lymphocytic leukemia include chromosome 13q deletion, chromosome 17p deletion, and chromosome 11q deletion. On microscopic histopathological analysis characteristic findings of chronic lymphocytic leukemia include small lymphoid cells, thin cytoplasmic border, lack of nucleoli, and presence of smudge cells.[1][2][3][4]

Pathogenesis

Genetics

  • Somatic gene mutations involved in the pathogenesis of chronic lymphocytic leukemia include:[3]

Microscopic Pathology

  • On microscopic histopathological analysis characteristic findings of chronic lymphocytic leukemia include:[2][3]
  • On Immunohistochemistry characteristic findings of chronic lymphocytic leukemia include:[4]
  • Shown below is a series of microscopic images seen in multiple myeloma:

References

  1. 1.0 1.1 1.2 1.3 Chronic Lymphocytic Leukemia (2015) https://en.wikipedia.org/wiki/B-cell_chronic_lymphocytic_leukemia Accessed on October 12, 2015
  2. 2.0 2.1 2.2 Nabhan C, Rosen ST (2014). "Chronic lymphocytic leukemia: a clinical review". JAMA. 312 (21): 2265–76. doi:10.1001/jama.2014.14553. PMID 25461996.
  3. 3.0 3.1 3.2 3.3 3.4 Hallek M (2015). "Chronic lymphocytic leukemia: 2015 Update on diagnosis, risk stratification, and treatment". Am J Hematol. 90 (5): 446–60. doi:10.1002/ajh.23979. PMID 25908509.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 Chronic Lymphocytic Leukemia. Libre Pathology (2015) http://librepathology.org/wiki/index.php/B_cell_small_lymphocytic_lymphoma/chronic_lymphocytic_leukemia Accessed on October, 12 2015

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