Various inclusions in chronic lymphocytic leukemia/small lymphocytic lymphoma.

Abstract

(A) Globular inclusions in peripheral blood lymphocytes in a 67-year-old woman with 5-year history of CLL managed with a “watch and wait” approach. Other findings included increased lymphocyte count of 270×10 9 /L, hemoglobin of 110 g/L, and platelets of 78×10 9 /L. Serum lactate dehydrogenase level was normal. Positron emission tomography/ computed tomography revealed multiple adenopathies with low SUV and no evidence of transformation. (B) Multiple crystalline inclusions in peripheral blood lymphocytes in a 60-year-old asymptomatic woman with axillary lymphadenopathies. Laboratory evaluations revealed the following: hemoglobin of 132 g/L, platelets of 212×10 9 /L, and lymphocytes of 3.7×10 9 /L. B-cells revealed clonal CLL phenotype on flow cytometry. Lymph node biopsy revealed lymphoid infiltrate with low Ki67 and positivity for CD20, CD23, and CD5. A diagnosis of SLL was established