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Chronic lymphocytic leukemia - Skin
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Chronic lymphocytic leukemia - Skin

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Contributors: Patricia Ting MD, Ben Barankin MD, Jeffrey D. Bernhard MD, Noah Craft MD, PhD, Lindy P. Fox MD, Lowell A. Goldsmith MD, MPH, Michael D. Tharp MD
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Synopsis

Chronic lymphocytic leukemia (CLL) is a monoclonal hematologic disorder characterized by an overproduction of predominantly immature, nonfunctional clonal B lymphocytes (between pre-B and mature B-cell stages). In some cases, abnormal cell characterization by cytogenics, oncogene expression, and cell surface immunoglobulins is used for determine optimum therapy.

CLL is the most common form of adult-onset leukemia in Western countries. The majority of CLL cases occur in older white adults (older than 55 years) and the elderly. Male-to-female ratio is approximately 1.7-2:1. In the United States, approximately 16,000 CLL cases are reported annually, which is likely an underestimation from underreporting. Herbicide exposure may contribute to the development of CLL; however, a definitive environmental factor has not been identified. CLL usually has an indolent course in the early phase followed by a more rapidly progressive course prior to death. Prognosis is variable. Aggressive forms of CLL have a high mortality rate within the first 5 years of diagnosis. Death can result from CLL complications, sepsis, transformation to high-grade lymphoma, or treatment toxicity.

Several staging systems are used for CLL. The modified Rai-Sawitsky system is used most often, especially in North America, while the Binet system is used in Europe.

The revised Rai-Sawitsky staging system is divided into low-, intermediate-, and high-risk categories:
  • Low risk – Lymphocytosis in blood and bone marrow.
  • Intermediate risk – Lymphocytosis in blood and bone marrow with one or more of lymphadenopathy, splenomegaly, or hepatomegaly.
  • High risk – Lymphocytosis with either one or more of anemia (less than 11 g/dL) or thrombocytopenia (less than 100 x 10^9/L).
The Binet staging is based on hemoglobin, platelets, and lymph node regions involved. Lymph node regions are divided into head and neck, bilateral axillary, bilateral inguinal, splenomegaly, and hepatomegaly.
  • Stage A – Hemoglobin greater than or equal to 10 g/dL, platelets greater than or equal to 100 x 10^9/L, and less than three regions with lymphadenopathy.
  • Stage B – Hemoglobin greater than or equal to 10 g/dL, platelets greater than or equal to 100 x 10^9/L, and more than three regions with lymphadenopathy.
  • Stage C – Hemoglobin less than 10 g/dL and/or platelets less than 100 x 10^9/L.
For more information, see OMIM.

Codes

ICD10CM:
C91.10 – Chronic lymphocytic leukemia of B-cell type not having achieved remission

SNOMEDCT:
51092000 – Chronic lymphocytic leukemia

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Last Updated: 09/06/2018
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Chronic lymphocytic leukemia - Skin
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Chronic lymphocytic leukemia : Fatigue, Fever, Night sweats, Lymphadenopathy, Weight loss, Pallor, Splenomegaly, PLT decreased, LYP increased, RBC decreased
Clinical image of Chronic lymphocytic leukemia
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