A Case of B-Prolymphocytic Leukemia / 대한혈액학회지

ABSTRACT

Prolymphocytic leukemia (PLL) is a member of chronic lymphoproliferative disorders with relatively distinct clinical, morphologic, immunologic and prognostic features. The diagnosis of PLL is determined by more than 55% of prolymphocytes in the peripheral blood. It is characterized by leukocytosis, massive splenomegaly with little or no lymphadenopathy, and male prevalence. In immunophenotyping, the majority (80%) of the cases express B cell markers and the rest (20%), T cell type. We experienced a case of B-PLL. The patient was a 65 year-old man who presented with marked leukocytosis (110.5x109/L) and 78% of characteristic prolymphocytes in the peripheral blood. The bone marrow aspirate showed 13.6% of prolymphocytes and coarse granular positivity of prolymphocytes in PAS stain. The immunophenotyping of the leukemic prolymphocytes revealed the positivity of surface immunoglobulin (IgM, lambda type), HLA- DR and CD19. The monoclonal gammopathy (IgM, lambda type) was also detectable in the patient's serum.