Most Common NHL in Adults
Key Point
Small lymphocytic lymphoma (SLL) / Chronic lymphocytic leukemia (CLL) is the most common non-Hodgkin lymphoma in adults, accounting for ~30% of all NHLs in Western populations and a significant proportion in India.
Epidemiology & Presentation
High-YieldNEET PG
SLL/CLL typically presents in patients >50 years with:
Histopathology & Immunophenotype
| Feature | SLL/CLL |
|---|
| Morphology | Small, mature-appearing lymphocytes; "soccer ball" or smudge cells on touch prep |
| CD markers | CD5+, CD19+, CD20+ (dim), CD23+ |
| Cytochemistry | Positive for acid phosphatase (TRAP-positive in hairy cell variant) |
| Prognosis | Indolent; Rai/Binet staging used |
Clinical Pearl
The CD5+ B-cell phenotype distinguishes SLL/CLL from other small B-cell lymphomas (follicular lymphoma is CD5−, CD10+).
Why SLL/CLL is Most Common
- 1.
Age-related incidence increases sharply after 50 years
- 2.
Indolent biology allows prolonged survival and accumulation of cases
- 3.
Often diagnosed on routine CBC before symptoms appear
- 4.
Accounts for ~25–30% of all lymphoid malignancies in developed countries
Mnemonic: "CLL is COMMON" — Chronic Lymphocytic Leukemia is the most common adult lymphoma.
