Prolymphocytic leukemia: histologic findings in atypical cases.

Significant enlargement of peripheral lymph nodes is not characteristic of prolymphocytic leukemia. The absence of this physical feature of the disease has been so consistent in previous reports that it has come to have considerable importance in the differential diagnosis of prolymphocytic leukemia. We describe two cases of prolymphocytic leukemia, in which, in sharp contrast to other published cases, striking lymphadenopathy was present throughout the clinical course. In one case, the disease responded dramatically, but briefly, to L-asparaginase. The immunologic characteristics of cells from lymph nodes suggested that in both cases, the leukemic process was B-cell type. The features of the prolymphocytic proliferation in lymph nodes and the utility of Wright-Giemsa stained touch preparations have been emphasized.