Abstract
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
× 109/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.
Keywords
Chronic lymphocytic leukemia - hyperleukocytosis - leukostasis
