The cells have scant cytoplasm, rounded nuclei, darkly clumped chromatin, and inconspicuous nuclei. Almost all cases of SLL include intermingled larger lymphoma cells with more open chromatin and more prominent nucleoli. Immunophenotyping may help to identify it because the malignant cells usually express clonal kappa or lambda light chains. They also aberrantly express T-cell antigens CD5 and CD43, in addition to another characteristic antigen, CD23. Although the slowly proliferating cells are sensitive to chemotherapeutic agents, chemotherapy is almost never curative and relapse inevitably follows.
Most studies find no benefit in treating patients until they develop symptoms.
A new and promising drug is fludarabine, but it has not been shown to prolong survival either. Small Lymphocytic Lymphoma, Plasmacytoid Type Note the 2 plasma cells in the upper half. SLL-plasmacytoid is an uncommon lymphoma affecting elderly patients. The presence of quantities of this large protein in the blood may produce hyperviscosity symptoms such as bleeding, confusion, fatigue, and oncotic plasma volume expansion. About one-third of patients show evidence of hepatitis C infection.