A case of chronic lymphocytic leukemia is presented with a review of the literature.
A 62 years old korean woman was admitted to the department of internal medicine
Soon Chun Hyang University Hospital on Nov 28th, 1988 because of headache and
urinary discomfort with splenomegaly and cervical lymphadenopathy. She showed
moderate leukocytosis(45, 400/u1) with absolute lymphocytosis(atypical lymphocytes), but
anemia and thrombocytopenia were not associated. After 2 days, atypical lymphocytes
are converted to small to medium sized mature lymphocytes(leukemic cells) with many
smudge cells.
On the bone marrow aspiration smeary, small to medium sized mature lymphocycles
and smudge cells were noted with decreased normal hematopoietic elements. The bone
marrow biopsy revealed interstitial infiltration of leukemic cells.
The positive results of surface marker studies of leukemic cells were 10% for surface
membrane immunoglobulin(Sm Ig), which is decreased
because of early stage in lymphocyte differentiation and 15% for E-rosette formation.
Terminal deoxynucleotidyl transferase(TdT) of leukemic cells was negative.
positive monoclonal antibody tests of leukemic cells were T1 : 36%, T11 : 10%, I2 :
88%, B4 : 82%, 82H5 : 34%, 82H3 : 5% and J5, MY9, MY7 were negative.
Chromosomal study of PHA-stimulated CLL lymphocytes reveals 46, XX, inv
9(pll:q21), The patient was placed on chlorambucil and had improvement of general
symptomes and signs, and physical status associated with marked reduction of leukocyte
level.
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