0
A 68-year-old male presents for further evaluation of fatigue and dyspnea on exertion. Physical examination reveals no hepatosplenomegaly or lymphadenopathy. Laboratory workup reveals leukocyte count of 67,000/.uL. hemoglobin of 6.LJ g/dl, and platelet count of 262.000/ .uL. Flow cytometry of peripheral blood is performed and reveals expression of CDS. CD19. CD20. and CD23. Peripheral slide is shown below.
What is the most likely underlying diagnosis?
- Mantle cell lymphoma (MCL)
- Chronic lymphocytic leukemia (CLL)
- Follicular lymphoma (FL)
- Chronic myeloid leukemia (CML)
- T-cell prolymphocytic leukemia (T-PLL)
Medicine
B. Peripheral blood smear reveals increased number of mature-appearing lymphocytes with clumped chromatin and small amount of cytoplasm. Flow cytometry reveals the typical signature ofCLL with expression of CDS, CD20, and CD23. Presence of CDS rules out the diagnosis ofFL, while expression of CD23 argues against MCL. Minority of the lymphocytes are of a larger size; however, they do not exhibit prominent nucleoli characteristic of prolymphocytes. Absence of the usual T-cell markers rules out the diagnosis ofT-PLL.
need an explanation for this answer? contact us directly to get an explanation for this answer