2. Introduction
• Peripheral B cell neoplasms
• CLL/SLL
• Most common in adults
• Median age group is 60 years
• M:F 2:1
• Absolute lymphocyte count >5000/mm³
3. Pathogenesis
• Chromosomal translocations are unlike
• Most common genetic anomalies – deletion of
13q14.3,11q,17p and trisomy12q
• Gain of function mutation in NOTCH1 receptor
4. Tumour cell growth largely confined to proliferation centers
Provide nutrients from microenvironment
Stromal cells in the proliferation center stimulate the NF-ҡB
Promote the cell growth & survival
5. Tumour cells rely signals from the B cell receptors
Signals are transduced by the BTK (Bruton tyrosine kinase)
Cell growth & survival
6. Morphology
• Proliferation centers are pathognomonic
• Large activated lymphocytes are gather in loose aggregates
• Blood smear
• Large number of small round lymphocyte
• Scanty cytoplasm
• Smudge cells – some of the cells disrupted during the process of
making smear
• Bone marrow
• Almost always involved by interstitial infiltrates or aggregates of
tumour cells
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10. Clinical features
• Often asymptomatic
• Symptomatic – Nonspecific
• Easy fatigability
• Weight loss
• Anorexia
• Generalized lymphadenopathy
• Hepatosplenomegaly
