B-CELL SMALL LYMPHOCYTIC LYMPHOMA WITH CIRCULATING GRANULAR PROLYMPHOCYTES AND A NOVEL TRISOMY-15 ANOMALY

A 53-year-old man presented with cervical lymphadenopathy and massive splenomegaly. Peripheral blood examination showed many prolymphocytes with cytoplasmic azurophilic granules, giving an initial impression of large granular lymphocytosis. The lymph node biopsy and immunohistoch emical study findings, however, were more compatible with a diagnosis of B-cell small lymphocytic lymphoma. The circulating prolymphocytes s howed restricted kappa light chain expression similar to the lymphoid infiltrate in the lymph node. Karyotypic analysis revealed trisomy 15, a chromosomal abnormality that has rarely been described in small lym phocytic lymphoma or chronic lymphocytic leukemia.