Cover Image

A case of chronic lymphocytic leukemia with massive ascites

Ipek Yonal, Esra Nazligul, Gulsum Tas, Mehmet Ramazan Agan, Mustafa Nuri Yenerel, Meliha Nalcaci
  • Ipek Yonal
    Department of Internal Medicine, Division of Hematology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey | ipekyonal@yahoo.com.tr
  • Esra Nazligul
    Department of Internal Medicine, Division of Hematology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
  • Gulsum Tas
    Department of Internal Medicine, Division of Hematology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
  • Mehmet Ramazan Agan
    Department of Pathology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
  • Mustafa Nuri Yenerel
    Department of Internal Medicine, Division of Hematology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
  • Meliha Nalcaci
    Department of Internal Medicine, Division of Hematology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey

Abstract

An 81-year old woman with a history of chronic lymphocytic leukemia (CLL) was admitted with night sweats and abdominal distension. A complete blood count showed hemoglobin 5 g/dL, white blood cell (WBC) count 28.5x109/L and platelets 38.4x109/L. Peripheral blood smear examination showed a large number of smudge cells and lymphocytosis composed of mature-looking lymphocytes with clumped nuclear chromatin. Computed tomography scan demonstrated enlarged cervical, axillary, paraaortic, retroperitoneal and mesenteric lymph nodes with concomitant omental thickening and ascites. Also, the liver and the spleen were enlarged in the presence of multiple ill-defined hypoechoic areas in the latter. Histopathological analysis of the cervical lymph node biopsy was consistent with CLL. Bone marrow examination showed diffuse infiltration of the marrow with small lymphocytes. Analysis of the ascitic fluid revealed an exudate with WBC 1220 cells/mL. Cytocentrifuge preparation of the ascitic fluid showed small mature lymphoid cells containing hyperchromatic nuclei with coarsely gran- ular chromatin. On flow cytometric analysis of the ascitic fluid, expression of CD5, CD19, CD20, CD22, CD23, CD45 and HLA-DR was compatible with a diagnosis of CLL, in accordance with the results of the peripheral blood analysis. The patient was treated with chemotherapy consisting of cyclophosphamide, vincristine and prednisolone but died within one month after development of non-chylous ascites.

Keywords

ascites, chronic lymphocytic leukemia, hematologic malignancies, lymphomas

Full Text:

PDF
HTML
Submitted: 2012-03-30 20:07:59
Published: 2012-11-13 17:32:55
Search for citations in Google Scholar
Related articles: Google Scholar
Abstract views:
857

Views:
PDF
331
HTML
911

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


Copyright (c) 2012 Ipek Yonal, Esra Nazligul, Gulsum Tas, Mehmet Ramazan Agan, Mustafa Nuri Yenerel, Meliha Nalcaci

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
 
© PAGEPress 2008-2018     -     PAGEPress is a registered trademark property of PAGEPress srl, Italy.     -     VAT: IT02125780185