2021年血液病理学会/欧洲血液病理学协会研讨会的第三个环节研究了慢性淋巴细胞白血病/小淋巴细胞淋巴瘤（CLL / SLL）和B细胞原浆细胞白血病（B-PLL）的发展和转化。小组审查了31个病例。在部分病例中，进行了免疫组织化学和分子遗传学测试，包括全外显子测序和表达谱分析。会议包括27例CLL / SLL病例和其他相关增生，3例B-PLL病例和1例小型B细胞淋巴瘤。淋巴结加速的CLL / SLL的诊断标准已经确定，但足外部疾病可能存在诊断挑战。里希特转化（RT）是一个广泛的术语，包括原始CLL / SLL克隆（或克隆不相关肿瘤）的真正转化。形态学、免疫表型和遗传谱系是经典和极不寻常的例子的多样化表现。在CLL / SLL中也可能遇到T细胞增殖。B细胞原浆细胞白血病是一种罕见的、诊断困难的疾病，由于其与其他淋巴细胞肿瘤的重叠性而变得复杂多样。研讨会强调了CLL / SLL和B-PLL在进展和转化方面的复杂性，以及RT和疾病进展的其他表现形式所伴随的诊断要点。分子遗传学研究对于诊断和确定克隆关系至关重要，并预测治疗反应和识别靶向治疗的耐药性。©作者（S）2023。由牛津大学出版社代表美国临床病理学会发表。保留所有权利。有关权限，请发送电子邮件至：journals.permissions@oup.com。

Session 3 of the 2021 Workshop of the Society for Hematopathology/European Association for Haematopathology examined progression and transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and B-cell prolymphocytic leukemia (B-PLL).Thirty-one cases were reviewed by the panel. Additional studies such as immunohistochemistry and molecular genetic testing, including whole-exome sequencing and expression profiling, were performed in select cases.Session 3 included 27 CLL/SLL cases and miscellaneous associated proliferations, 3 cases of B-PLL, and 1 case of small B-cell lymphoma. The criteria for -accelerated CLL/SLL are established for lymph nodes, but extranodal disease can be diagnostically challenging. Richter transformation (RT) is a broad term and includes true transformation from original CLL/SLL clone(s) and clonally unrelated neoplasms. The morphologic, immunophenotypic, and genetic spectrum is diverse with classical and highly unusual examples. T-cell proliferations can also be encountered in CLL/SLL. B-cell prolymphocytic leukemia is a rare, diagnostically challenging disease due to its overlaps with other lymphoid neoplasms.The workshop highlighted complexity of progression and transformation in CLL/SLL and B-PLL, as well as diagnostic caveats accompanying heterogeneous presentations of RT and other manifestations of disease progression. Molecular genetic studies are pivotal for diagnosis and determination of clonal relationship, and to predict response to treatment and identify resistance to targeted therapy.© The Author(s) 2023. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.