Chronisch lymphatische Leukämie vom B-Zellen-Typ: Klinische und morphologische Untersuchungen zur diagnostischen Abgrenzung

Chronic lymphatic leukemia (CLL) was diagnosed in 71 patients based on clinical data. Most of the patients were in the stages 0, I and II, only 18% were in the stages III and IV according to Rai. In all cases, the disease was characterized by an increased number of B lymphocytes (B-CLL). The B cells mostly expressed a weak fluorescence intensity when tested for membrane bound immunoglobulins (Ig). In accordance to that, the quantitative measurement of Ig in the serum revealed a decrease of one or more Ig classes in 72% of the patients. No correlation existed between the number of B lymphocytes (and T lymphocytes) or the Ig concentration in the serum and the stage of the disease. To distinguish the CLL from related lymphoproliferative disorders, especially the immunocytic lymphoma, lymphnode biopsies were examined histologically and immunomorphologically for intracytoplasmic Ig. This examination confirmed the diagnosis of CLL in 33 out of 40 cases. Six lymphnodes were classified as immunocytic lymphoma of the lymphoplasmacytoid type. In three of the latter, the immunocytic lymphoma was clinically associated with decreased Ig concentrations in the serum. These findings emphasize that the clinically established diagnosis of CLL should be corroborated by immunomorphology.