Leukemia B-cell prolymphocytic

B-cell prolymphocytic leukemia rarely presents as a diagnostic dilemma in a lymph node, and although splenic involvement may raise the possibility of a splenic lymphoma, the elevated white blood cell count and typical smear make this unlikely. B-PLL may be CD5 and CD23 negative and is more likely to be CD22 positive than B-CLL/SLL.Not surprisingly, measures of mitotic index—such as Ki-67 —are higher in B-PLL. 

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