Diagnostic Problems Among Chronic Lymphocytic Leukemia and Other Indolent B-cell Leukemias in a Japanese Population
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概要
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Objective Japanese chronic lymphocytic leukemia (CLL) provides a diagnostic dilemma due to the low incidence and the heterogeneity shown in its morphology and immunophenotype. We clarified the diagnostic problems in Japanese CLL through our retrospective observation. Methods Between 2006 and 2011, we found a total of 48 cases with CLL and other indolent B-cell leukemias. We made a diagnosis of true CLL based on clinical, laboratory, immunophenotypic and cytogenetic data. Results Among the 48 cases, only 28 cases (58.3%) were diagnosed with true CLL. Morphologic evaluation using a forced-air dried preparation alone is not helpful to distinguish CLL from other indolent B-cell leukemias, including hairy cell leukemia, mantle cell lymphoma, lymphoplasmacytic lymphoma, and splenic marginal zone lymphoma. CLL immunophenotypic score should be more strictly applied in Japan than in Western countries. Conclusion Fluorescence in situ hybridization for CCND1/IGH, the presence of leukocytosis and lymphadenopathy at diagnosis, and the morphological evaluation using naturally air dried preparations are important clues to make a correct diagnosis of Japanese CLL.
著者
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Sasaki Makoto
Deparment Of Mathematical System Science Faculty Of Science And Technology Hirosaki University
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SUGIMOTO Koichi
Department of Aeronautics and Astronautics, Faculty of Engineering Kyushu University
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Komatsu Norio
Department of Hematology Juntendo University Hospital
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Komatsu Norio
Department of Hematology, Juntendo University School of Medicine, Japan
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Tsukada Nobuhiro
Department of Medicine, Japanese Red Cross Medical Center, Japan
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Tsukada Nobuhiro
Department of Hematology and Oncology, Institute of Medical Science University of Tokyo
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Isobe Yasushi
Department of Hematology, Juntendo University School of Medicine, Japan
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Tomomatsu Junichi
Department of Hematology, Juntendo University School of Medicine, Japan
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Tsukune Yutaka
Department of Hematology, Juntendo University School of Medicine, Japan
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Isobe Yasushi
Department of Hematology, Juntendo University School of Medicine
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Sugimoto Koichi
Department of Hematology, Juntendo University School of Medicine, Japan
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