Abstract

Chronic lymphocytic leukaemia (CLL) is a mature B-cell neoplasm predominantly affecting older adults and is often diagnosed incidentally. We report a case of a 45-year-old male presenting with severe anaemia, thrombocytopenia, massive lymphadenopathy, and bilateral pulmonary nodular lesions. Peripheral smear, flow cytometry, lymph node biopsy, and lung biopsy confirmed CLL/small lymphocytic lymphoma (SLL) with pulmonary infiltration. Fluorescence in situ hybridisation (FISH) revealed an isolated deletion of chromosome 13q14 in 75% of cells. Due to financial constraints, the patient received rituximab and chlorambucil instead of a Bruton tyrosine kinase inhibitor. Clinical improvement, with reduced lymphadenopathy and symptomatic relief, was observed at subsequent follow-up. This case highlights that typical morphology and immunophenotype may coexist with aggressive clinical features in younger patients and underscores the importance of extended molecular evaluation.

Keywords

chronic lymphocytic leukaemia, Del (13q), pulmonary infiltration, young-onset cll, extranodal involvement