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Histologic and immunohistochemical findings in the differential diagnosis of chronic lymphocytic leukemia of B-Cell type and lymphoplasmacytic/lymphoplasmacytoid lymphoma

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Summary

114 cases of malignant lymphoma consisting chiefly of lymphocytes were classified by histology as chronic lymphocytic leukemia of the B-cell type (B-CLL) or lymphoplasmacytic/lymphoplasmacytoid lymphoma (LP immunocytoma) and investigated with the immunoperoxidase-bridge (PAP) method for the presence of heavy and light immunoglobulin chains. Fifteen cases were excluded because they showed a completely negative reaction, which might have been an artifact. Of the remaining 99 cases, 46 revealed polyclonal immunoglobulin-positive plasma cells only and could be clearly classified as B-CLL. In 33 cases there were a moderate or large number of plasma cells or plasmacytoid cells with monoclonal intracytoplasmic positivity. Two heavy chain classes were demonstrated in three other cases, and both light chain types were detected in one case. These 37 cases were finally classified as LP immunocytoma. Ten cases contained only a few monoclonal plasmacytoid cells and were interpreted as borderline cases between B-CLL and LP immunocytoma. Six cases have not yet been clarified — there was an inexplicable discrepancy between their histology and immunostaining.

In LP immunocytoma, the heavy chain class demonstrated most often was the μ chain (27 cases). Light chains of the κ type were about 2.5 times as common as λ chains.

The differential diagnostic criteria for distinguishing B-CLL from LP immunocytoma are discussed and compared. PAS-positive tumor cells are an almost definite criterion of LP immunocytoma. At present, a critical evaluation of the results of PAP immunostaining is the most reliable way to clearly distinguish B-CLL from LP immunocytoma.

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Author notes

  1. Constantin S. Papadimitriou

    Present address: Department of Pathology, University of Athens, Athens (Goudi) 617, Greece

Authors and Affiliations

  1. Lymph Node Registry, Institute of Pathology, University of Kiel, Hospitalstr. 42, D-2300, Kiel, Federal Republic of Germany

    Constantin S. Papadimitriou, Ulrike Müller-Hermelink & Karl Lennert

Authors
  1. Constantin S. Papadimitriou
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  2. Karl Lennert
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Supported by the Kind-Philipp-Stiftung

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Papadimitriou, C.S., Müller-Hermelink, U. & Lennert, K. Histologic and immunohistochemical findings in the differential diagnosis of chronic lymphocytic leukemia of B-Cell type and lymphoplasmacytic/lymphoplasmacytoid lymphoma. Virchows Arch. A Path. Anat. and Histol. 384, 149–158 (1979). https://doi.org/10.1007/BF00427252

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