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Accounting for about 4% of NHL, SLL is a slowly progressing form of lymphoma which shows considerable overlap with chronic lymphocytic leukaemia (CLL). The majority of patients are over 60 years of age and present with generalised lymphadenopathy and involvement of the bone marrow, spleen and peripheral blood¹. Survival rates are dependent on bone marrow involvement and range from approximately 2 to 12 years. The pattern of bone marrow involvement (diffuse versus interstitial or nodular) has been shown to have prognostic significance. The lymph node structure is replaced by small round B-lymphocytes interspersed with larger cells with prominent nuclei. Occasional large cells called paraimmunoblasts are also present and may be clumped with prolymphocytes into ill-defined nodules called pseudofollicles. An atypical morphology with an increased number of prolymphocytes is an independent factor with adverse prognosis. The tumour cells weakly express surface immunoglobulins, which are generally of IgG and/or IgM isotypes. The B-cell antigens CD19 and CD20 are expressed, although expression of CD20 is usually below that observed in normal B-cells. The majority of cases also express CD5 and CD43².

References

1. Evans LS, Hancock BW. Non-Hodkin's Lymphoma. Lancet 2003;362:139-46.
2. Gribben J, et al. In: Non-Hodgkin's lymphomas. Mauch P, Armitage J, Coiffier B, Dalla-Favera R, Harris N, ed. Lippincott Williams & Wilkins 2004:243-61