Case history
Case history #1
A 62-year-old man presents at the primary care physician's office for an annual physical. He denies any fever or chills, weight loss, or fatigue. Of note, his blood tests show an elevated white blood cell (WBC) count. The WBCs are predominantly lymphocytes, with a differential of 80% lymphocytes and an absolute lymphocyte count of 75,000 cells/microliter (75 × 10⁹/L).
Case history #2
A 60-year-old man presents with swollen lymph nodes in the cervical and inguinal region that have been present for 2 months and are gradually increasing in size. The lymphadenopathy is painless and has not responded to a course of antibiotics prescribed by the primary care physician. The patient denies any recent history of infection, fever, or chills. A blood test shows an elevated WBC count. The WBCs are predominantly lymphocytes, with a differential of 88% lymphocytes and an absolute lymphocyte count of 80,000 cells/microliter (80 × 10⁹/L).
Other presentations
The majority of patients present with lymphadenopathy.[3] Around half present with splenomegaly, and around 14% will present with hepatomegaly.[4] One quarter of patients are asymptomatic and have an elevated absolute lymphocyte count on a routine blood test. B symptoms (fever, drenching night sweats, unintentional weight loss) and and other symptoms (e.g., chills, fatigue) occur in approximately 10% of patients with CLL.[4]
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