Chronic lymphocytic leukaemia

Dr Owen Kang and Dr Yuranga Weerakkody et al.

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 with the disease being incidentally discovered by a routine blood work up 3. Patients may sometimes 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 signal of bone structures 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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Article Information

rID: 17441
System: Haematology
Section: Pathology
Tags: cases, leukaemia
Synonyms or Alternate Spellings:
  • CLL
  • B cell chronic lymphocytic leukaemia
  • Chronic lymphocytic leukaemia (CLL)
  • Chronic lymphocytic leukemia
  • B cell chronic lymphocytic leukemia
  • B-cell chronic lymphocytic leukaemia
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    Case 1: with spinal cord infiltration
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    Case 2: widespread lymphadenopathy
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