Coding Manual:
Hematopoietic Coding Manual (PDF)
Abstractor Notes
This neoplasm affects the peripheral blood (PB), bone marrow (BM) and spleen. Prolymphocytes must exceed 55% of lymphoid cells in PB. The leukemic cells are found in the PB, BM and spleen.
Diagnostic Confirmation
This histology can be determined by positive histology (including peripheral blood) with or without genetics and/or immunophenotyping. Review the Definitive Diagnostic Methods, Immunophenotyping and Genetics Data sections below, and the instructions in the Hematopoietic Manual for further guidance on assigning Diagnostic confirmation.
Grade
Not Applicable
Module Rule
None
Alternate Names
B-PLL
Prolymphocytic leukemia, B-cell type
Definition
B-cell prolymphocytic leukemia (B-PLL) is a neoplasm of B-cell prolymphocytes affecting the peripheral blood, bone marrow, and spleen. Prolymphocytes must constitute > 55% of lymphoid cells in peripheral blood.
Definitive Diagnostic Methods
Bone marrow biopsy
Genetic testing
Immunophenotyping
Peripheral blood smear
Immunophenotyping
CD5+ (expression/positive)
CD19+ (expression/positive)
CD20+ (expression/positive)
CD22+ (expression/positive)
CD23+ (expression/positive)
CD38+ (expression/positive)
CD79a+ (expression/positive)
CD79b+ (expression/positive)
CD200+ (expression/positive)
FMC7+ (expression/positive)
Strong surface IgM +/- IgD
Treatments
Chemotherapy
Hormone therapy
Radiation therapy
Transformations to
There are no known transformations
Transformations from
There are no known transformations
Same Primaries
Corresponding ICD-9 Codes
204.8 Other lymphoid leukemia
Corresponding ICD-10 Codes
C91.3 Prolymphocytic Leukemia
Corresponding ICD-10-CM Codes (U.S. only)
C91.3 Prolymphocytic leukemia of B-cell type (effective October 01, 2015)
Signs and Symptoms
Anemia
Massive splenomegaly
Rapidly rising lymphocyte count
Thrombocytopenia
Peripheral lymphadenopathy (minimal)
Diagnostic Exams
Blood chemistry studies
Bone marrow aspiration and biopsy
CT (CAT) scan
Cytogenetic analysis
Immunophenotyping
Peripheral blood smear
Progression and Transformation
None
Epidemiology and Mortality
Age: 65-69 years median age
Incidence: ~1% of lymphocytic leukemias
Sex: no male or female predominance
Survival: 30-50 months median survival
Sources
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J (Eds):
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Mature B-cell neoplasms
Pages: 222-223
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Mature B-cell neoplasms
Pages: 222-223
International Classification of Diseases for Oncology, Third Edition, Second Revision. Geneva: World Health Organization, 2020.
Section: ICD-O-3.2 (2020) Morphological Codes
Pages: http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577
Section: ICD-O-3.2 (2020) Morphological Codes
Pages: http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577