Chronic lymphocytic leukemia (CLL) is a haematologic 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.
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 hemolytic anemia.
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.
As with other types 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.
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- 2. Ghofrani M, Tantiwongkosi B, Smith AS et-al. Richter transformation of chronic lymphocytic leukemia presenting as a dural-based non-hodgkin lymphoma mass. AJNR Am J Neuroradiol. 2007;28 (2): 318-20. AJNR Am J Neuroradiol (full text) - Pubmed citation
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