Chronic Lymphocytic Leukemia Differential Diagnoses

  • Author: Muhammad A Mir, MBBS, FACP; Chief Editor: Emmanuel C Besa, MD   more...
 
Updated: Apr 27, 2012
 
 

Diagnostic Considerations

Mantle cell lymphoma can have a clinical presentation very similar to chronic lymphocytic leukemia (chronic lymphoid leukemia, CLL) but more aggressive.

Several features aid in the distinction of mantle cell lymphoma from CLL. Mantle cell lymphoma expresses CD5 and CD19 but not CD23 antigen, which is expressed in CLL. Mantle cell lymphoma typically expresses FMC-7. Importantly, expression of CD20 is bright in mantle cell lymphoma, whereas it is dim in CLL.

Anemia secondary to bone marrow involvement with CLL, splenic sequestration of red blood cells, and autoimmune hemolytic anemia associated with a positive Coombs test are included in the differential diagnosis of a patient with anemia who has CLL.

Another problem to be considered is splenic lymphoma with villous lymphocytes.

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Muhammad A Mir, MBBS, FACP  Attending Physician, Department of Medicine, Eastern Maine Medical Center

Muhammad A Mir, MBBS, FACP is a member of the following medical societies: American College of Physicians and American Society of Hematology

Disclosure: Nothing to disclose.

Coauthor(s)

Delong Liu, MD, PhD  Associate Professor of Medicine, Division of Oncology/Hematology, New York Medical College; Chief of Hematology, Phelps Memorial Hospital Center; Director of Non-ablative Allogeneic Stem Cell Transplantation Program, Westchester Medical Center; Editor-in-Chief, Journal of Hematology and Oncology

Delong Liu, MD, PhD is a member of the following medical societies: American Society of Clinical Oncology and American Society of Hematology

Disclosure: Nothing to disclose.

Samir C Patel, MD  Fellow, Department of Hematology and Medical Oncology, Metropolitan Hospital, New York Medical College

Disclosure: Nothing to disclose.

Michael Perry, MD, MS, MACP  Nellie B Smith Chair of Oncology Emeritus, Director, Division of Hematology and Medical Oncology, Deputy Director, Ellis Fischel Cancer Center, University of Missouri-Columbia School of Medicine

Michael Perry, MD, MS, MACP is a member of the following medical societies: Alpha Omega Alpha, American Association for Cancer Research, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society of Clinical Oncology, American Society of Hematology, International Association for the Study of Lung Cancer, and Missouri State Medical Association

Disclosure: Nothing to disclose.

Haleem J Rasool, MD, FACP  Hematologist/Oncologist, Department of Oncology, Franciscan Skemp Healthcare

Haleem J Rasool, MD, FACP is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine and American Society of Hematology

Disclosure: Nothing to disclose.

Chief Editor

Emmanuel C Besa, MD  Professor, Department of Medicine, Division of Hematologic Malignancies, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University

Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Clinical Oncology, American Society of Hematology, and New York Academy of Sciences

Disclosure: Nothing to disclose.

Additional Contributors

Clarence Sarkodee-Adoo, MD Consulting Staff, Department of Bone Marrow Transplantation, City of Hope Samaritan BMT Program

Disclosure: Takeda Millenium Honoraria Speaking and teaching

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

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Peripheral smear from a patient with chronic lymphocytic leukemia, small lymphocytic variety.
Peripheral smear from a patient with chronic lymphocytic leukemia, large lymphocytic variety. Smudge cells are also observed; smudge cells are the artifacts produced by the lymphocytes damaged during the slide preparation.
 
 
 
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