Lymphosarcoma cell leukemia.A clinicopathologic study

Lymphosarcoma cell leukemia (LSCL) represents a poorly-differentiated lymphocytic lymphoma which has involved the peripheral blood and bone marrow (leukemic phase of poorly-differentiated lymphocytic lymphoma). the clinical, biopsy, and necropsy findings of 18 patients with LSCL were reviewed. the histologic pattern of the lymphoma in the original lymph node biopsy of 16 patients was nodular (follicular) in 10 and diffuse in 6. the differences in histologic pattern of the lymphoma were related to the clinical course and prognosis of the patients. Four of the 6 patients who had a diffuse histologic pattern were leukemic at the time of lymph node biopsy. in contrast, only one of 10 patients with a nodular lymphoma was leukemic at the onset. the total survival (preleukemic and leukemic phases) as well as the survival of the leukemic phases were considerably better in those patients who initially had a nodular type of lymphoma than in those patients with a diffuse type of lymphoma. At the time of necropsy, all patients had dissemination of lymphoma (leukemia) throughout the body, and the majority of those who originally had a nodular histologic pattern had a diffuse pattern at necropsy. Separation of LSCL from other types of lymphocytic leukemias seems to be valid on morphological grounds as well as on the basis of clinical course, response to therapy, and, especially, prognosis which is considerably worse in LSCL than in chronic lymphocytic leukemia.