PMC6204171_01
(a) H&E shows infiltrate of small lymphocytes x50. (b) Immunohistochemistry of CD20 highlighting the lymphocytes x50.
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fig1
Bone marrow biopsy revealed hypercellularity with diffuse infiltrate of the medium to large-sized mononuclear cells with irregular nuclear contours and prominent nucleoli similar to that seen in the peripheral blood smear (Figure 1).
CSF flow cytometry.
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fig2
Repeat CSF studies at our hospital showed lymphocytes accounting for 49% of total events per flow cytometry, positive for CD19, CD20, CD5, and CD23, with lambda light chain restriction, and negative for CD10 and FMC-7 (Figure 2).