Chronic lymphocytic leukemia

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.

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

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.

Share article

Article information

rID: 17441
System: Haematology
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

Support Radiopaedia and see fewer ads

Cases and figures

  • Case 1: with spinal cord infiltration
    Drag here to reorder.
  • Case 2: widespread lymphadenopathy
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.