Chronic Lymphocytic Leukemia
Chronic lymphocytic leukemia is a neoplatic disease
Pathophysiology
1) chronic lymphocytic leukemia is a neoplastic disorder with clonal proliferation of lymphocytes
2) 95% of cases are B cell in origin
3) primary site of involvement is the bone marrow (eventually bone marrow becomes completely replaced) with release into bloodstream of neoplastic lymphocytes
4) spleen, liver, and lymph nodes may become enlarged
5) 10 % of patients convert to prolymphocytic leukemia (most with more aggressive course)
6) 5% of patients with chronic lymphocytic leukemia convert to Richter’s syndrome
Signs and Symptoms of Chronic Lymphocytic Leukemia
1) can be very indolent with very few symptoms for years
2) splenomegaly is most striking physical finding of chronic lymphocytic leukemia
3) lymphadenopathy
4) recurrent infections (especially bacterial but can also be viral and fungal)
5) development of autoimmune hemolytic anemia
6) bleeding episodes and epistaxis
7) Richter’s syndrome – fever, abdominal pain, progressive lymphadenopathy, and hepatomegaly
Characteristic Test Findings
Laboratory
1) chronic lymphocytic leukemia (CLL) has significant increase in lymphocytes (both B and T cells)
2) anemia
3) granulocytopenia
4) thrombocytopenia (decreased platelets)
5) positive Coombs test (20%)
Histology/Gross Pathology
1) “smudge cell” on peripheral smear (ruptured cell membrane is characteristic)
2) diffuse effacement of normal lymph node with small lymphocytes
Smudg...
Source: Inside Surgery - Category: Surgeons Authors: Editor Tags: Oncology chronic lymphocytic leukemia CLL prolymphocytic Richter's smudge cell Source Type: blogs
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