Atwal Dinesh, Raval Mihir, Firwana Belal, Ramos Jeanette, Sasapu Appalanaidu
Department of Hematology Oncology, University of Arkansas for Medical Sciences, Winthrop Rockefeller Cancer Institute, Little Rock, Arkansas, USA.
Avicenna J Med. 2017 Jul-Sep;7(3):133-136. doi: 10.4103/ajm.AJM_171_16.
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is a B-cell lymphocytic neoplasm with indolent clinical course. If identified early, observation is opted. Many variables lead to the initiation of treatment. Authors describe a 62-year-old male presenting with shortness of breath and found to have white cell count of 1360 × 10/L and subsequently was diagnosed with CLL/SLL. The patient received leukapheresis along with tumor lysis treatment and systemic chemotherapy with fludarabine, cyclophosphamide, and rituximab regimen. His course was complicated with deep venous thrombosis, extensive cutaneous, and sinus mucosa involvement by CLL/SLL. The patient clinically improved and on follow-up clinic visits documented normalization of his white cell counts. The case report brings up a rare presentation of CLL/SLL with such an extreme high white cell count, leukostasis symptoms and extramedullary involvement of disease and encourages providers to be vigilant of rare presentation of CLL/SLL.
慢性淋巴细胞白血病/小淋巴细胞淋巴瘤（CLL/SLL）是一种临床病程进展缓慢的B细胞淋巴细胞肿瘤。如果早期确诊，可选择观察等待。许多因素会促使开始治疗。作者描述了一名62岁男性，因气短就诊，白细胞计数为1360×10⁹/L，随后被诊断为CLL/SLL。该患者接受了白细胞单采术以及肿瘤溶解治疗，并采用氟达拉滨、环磷酰胺和利妥昔单抗方案进行全身化疗。他的病程中出现了深静脉血栓形成、CLL/SLL广泛累及皮肤和鼻窦黏膜等并发症。患者临床症状改善，随访门诊记录显示其白细胞计数恢复正常。该病例报告提出了CLL/SLL一种罕见的表现形式，即白细胞计数极高、有白细胞淤滞症状以及疾病的髓外累及，这促使医疗人员对CLL/SLL的罕见表现保持警惕。
