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A 62 -year-old male presen ts for evaluation of bilateral cervical, axi l lary, and inguinal lymphadenopathy. Physical exami nation con firms these fi ndi ngs in addition to disclos-ing splenomegaly. Laboratory evaluation reveals leukocyte count of 70,000/pL hemoglobin of 9.6 g/dl, and platelet count of 1 38 , 000/JLL. Flow cytometry reveals increased population of cel ls expressing CDS , CD 1 9 , CD2 0, and CD2 3. Peripheral blood smear is shown below.
What is the most likely diagnosis?
- Mantle cell lymphoma (MCL)
- Chronic lymphocytic leukemia (CLL)
- Follicular lymphoma (FL)
- Chronic myeloid leukemia (CML)
- Acute lymphoblastic leukemia (ALL)
Medicine
B. The presence of an increased number of mature-appearing lymphocytes with small amount of cytoplasm and clumped chromatin, in addition to flow cytometry revealing increased expression of CDS, CD20, and CD23 is characteristic of CLL. Positivity for CD23 differentiates CLL from MCL.
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