Abstract
Key Clinical MessageDiffuse large B‐cell lymphoma in rare instances can present initially in a leukemic phase and mimic other lymphoid diseases. In such cases, advanced diagnostic testing including immunophenotyping, FISH analysis, and karyotyping can help determine the accurate diagnosis which is key in the management of the disease.
Highlights
A 59-year-old presented to oncology clinic with a 15-lb. weight loss, right-sided Bell’s palsy, and back pain
A peripheral smear demonstrated a predominant population of abnormal medium- to large-sized lymphoid cells with mildly irregular to clefted nuclei, coarsely dispersed chromatin, prominent nucleoli, and small to moderately abundant basophilic cytoplasm (Fig. 1A)
The main population (69% of events) consisted of medium- to large-sized B cells that were CD10+, CD19 variably dim+, CD20+, CD22 variably dim+, CD38 bright+, CD45+, FMC-7+, kappa+, CD5, CD23, and lambda
Summary
A 59-year-old presented to oncology clinic with a 15-lb. weight loss, right-sided Bell’s palsy, and back pain. Diffuse large B-cell lymphoma in rare instances can present initially in a leukemic phase and mimic other lymphoid diseases. Two weeks’ prior the patient’s CBC demonstrated a WBC count of 7600/ll, hemoglobin of 9.5 g/dL, and platelets of 112,000/lL.
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