Department of Pulmonology, Mohamed VI University Hospital, Marrakech, Morocco.
Case Study
World Journal of Advanced Research and Reviews, 2024, 24(02), 1503-1507
Received on 27 October 2024; revised on 02 December 2024; accepted on 05 December 2024
Pleural involvement revealing chronic lymphocytic leukemia (CLL) is a rare phenomenon. CLL is a hematologic malignancy characterized by an excessive proliferation of B lymphocytes. Although CLL typically presents with symptoms such as fatigue, frequent infections, and lymphadenopathy, in some cases, it may initially manifest with pleural involvement. This involvement can present as a pleural effusion, leading to symptoms such as dyspnea, chest pain, and a dry cough. Diagnosis relies on cytological analysis of pleural fluid, biopsy, and additional tests such as immunophenotyping. Management includes treatment of the underlying CLL, often with a combination of chemotherapy and immunotherapy.
We report the case of a 53-year-old male, a former farmer and chronic smoker, who presented with stage III dyspnea (according to Sadoul), dry cough, and right-sided lower thoracic pain. These symptoms were associated with a general decline in his health status. Clinical examination revealed signs of right-sided pleural effusion, multiple lymphadenopathies (cervical, axillary, inguinal), and hepatosplenomegaly. Laboratory tests showed significant lymphocytosis. A pleural puncture revealed a lymphocytic exudative fluid, and pleural biopsy showed granulomatous inflammation without caseous necrosis. Immunohistochemistry highlighted an abnormal population of B lymphocytes expressing CD19, CD5, CD20, CD23 markers, and a monoclonal population with a predominance of the kappa light chain, thus confirming the diagnosis of chronic lymphocytic leukemia.
After confirmation of the stage C CLL diagnosis, the patient was treated with chemotherapy (CHOP protocol).
Chronic lymphocytic leukemia (CLL); Pleural effusion; Hyperlymphocytosis; Pleural biopsy; Chemotherapy
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Meriem EL MOUDEN, Oussama Fikri, Mohamed Ijim and Lamyae Amro. Pleural involvement revealing chronic lymphocytic leukemia: A case report. World Journal of Advanced Research and Reviews, 2024, 24(3), 1503-1507. Article DOI: https://doi.org/10.30574/wjarr.2024.24.3.3703