Small Lymphocytic Lymphoma

General: Small lymphocytic lymphoma (SLL) represents approximately 7% of non-Hodgkin's lymphomas (NHLs)1 and presents in adulthood with a median age

Figure 52.1 Schema of B-cell development and lymphoma. (Modified from Ref. 109, with permission of the International Agency for Research on Cancer.)
Figure 52.2 SLL, low magnification shows a diffuse infiltrate of small lymphocytes with a central pale area representing a proliferation center

of 65 years and a 2:1 male predominance. It is the tissue equivalent of chronic lymphocytic leukemia (CLL).

Pathology: SLL is a diffuse process that effaces lymph node architecture with a small lymphoid infiltrate. The cells have condensed chromatin, round nuclear contours, and scant cytoplasm. As in CLL, intermediate-sized lymphocytes with slightly open chromatin and a small central nucleolus (paraim-munoblasts) are always present and oftentimes aggregate to form proliferation centers (Figures 52.2 and 52.3). Increased numbers of paraimmunoblasts can be seen in biopsies and this does not constitute a transformation of SLL. Only when sheets of large cells are present does one consider a large cell transformation of SLL to diffuse large B-cell lymphoma (a form of Richter syndrome)

Table 52.1

Frequency of chromosomal abnormalities3


Percentage of cases

13q deletion

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