Key points are not available for this paper at this time.
A 56-year-old woman with no significant prior medical history had a routine CBC that showed an elevated WBC count of 25.8, hematocrit level of 37.6, and platelet count of 210,000. A differential revealed 52% lymphocytes and 26% neutrophils. A cervical lymph node biopsy showed effacement of the normal nodal architecture by a uniform population of small lymphoid cells and scattered larger cells. Flow cytometry revealed a monotypic kappa population of cells that expressed CD20, CD5, and CD23. Confirmatory peripheral blood flow cytometry showed kappa predominance, CD20, CD5, CD23, and CD38 -. The diagnosis was consistent with chronic lymphocytic leukemia (CLL). There were no constitutional symptoms. A computed tomography (CT) scan of the neck, chest, abdomen, and pelvis was remarkable for cervical, axillary, intra-abdominal, pelvic, and inguinal lymphadenopathy. The spleen was mildly enlarged. Figure A 18 Ffluorodeoxyglucose ( 18 FFDG) positron emission tomography (PET)/CT scan performed at this time revealed mild uptake in multiple lymph node stations. In Figure
Giardino et al. (Tue,) studied this question.