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Case Report Volume 14 Issue 1
Pulmonary nodular infiltration in a young patient with chronic lymphocytic leukaemia and isolated Del (13q): Atypical clinical aggressiveness with typical immunophenotype
Dr Seema Achaya, Dr Saqib Ahmed, Dr Sanjhali Singh, Dr Rachit Ahuja
Received: April 24, 2026 | Published: May 20, 2026
Citation: Achaya S, Ahmed S, Singh S, et al. Pulmonary nodular infiltration in a young patient with chronic lymphocytic leukaemia and isolated Del (13q): Atypical clinical aggressiveness with typical immunophenotype. Hematol Transfus Int. 2026;14(1):11-13. DOI: 10.15406/htij.2026.14.00352
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
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