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Chronic lymphocytic leukaemia

Chronic lymphocytic leukaemia (CLL) is a haematological malignancy. 


CLL is considered the most common type of leukemia in the Western hemisphere; its prevalence in Europe and North America ranges from 29 - 38% of all leukaemias 1. It primarily affects adults ~ 65 - 70 years of age 3.

Clinical presentation

Up to half of patients can be asymptomatic where the disease incidentally discovered by a routine blood work up 3. Patients may some types present with hepatomegaly, splenomegaly or both and / or a haemolytic anaemia.


It is a B-lineage neoplasm of pre-follicular center cells that is usually associated with circulating neoplastic small lymphocytes. From a morphologic and immunophenotypic perspective, the malignant cells of CLL tend to be identical to those of nodal-based small lymphocytic lymphoma (SLL), and these two malignancies are thought to represent different manifestations of the same disease 1.


There are two common staging system in use which are


The diagnosis is generally established by a bone marrow biopsy and immunophenotyping.

Radiographic features

Imaging may identify various features of the disease such as splenomegaly, hepatomegaly + / - lymphadenopathy, although these are not specific for the disease.


As other type of bone marrow infiltrative disease, it is possible to see a diffusely hypointense signa of bone structuresl on T1, easier to see on spinal MRI.


  • Richter transformation: is defined as a diffuse large cell lymphoma, occurring by transformation of chronic lymphocytic leukemia 2,4.

See also

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