PMC9242704_01
(a) shows the flow cytometry at the time of admission. Proliferation of monotypic B lymphocytes, which constitute 89% of lymphocytes and display CD19+, CD 20+, CD22+, CD5+, CD23+, HLA DR+, immunophenotypes, was detected. (b) shows the flow cytometry 1 year after discharge. Proliferation of monotypic B lymphocytes which compatible with CLL, was not detected.
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In peripheral blood flow cytometry, proliferation of monotypic B lymphocytes, which constitute 89% of lymphocytes and display CD19+, CD 20+, CD22+, CD5+, CD23+, HLA DR+ immunophenotypes, was detected (Fig.1a).
(a) Multiple enlarged lymphadenopathies, the largest of which was 30 x 17 mm in mediastinum. (b) PET CT revealed regression of mediastinal lymphadenopathies, after recovery of Covid 19. (c) CD4+ T lymphocyte infiltration in bone marrow. (d) CD8+ T lymphocyte infiltration in bone marrow. (e) leukocyte graph.
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Mediastinal lymphadenopathies are shown in Fig. 2a. T lymphocyte infiltration (Fig. 2c and 2d). Two months after admission, fever dropped and the patient was discharged to home. Three months after discharge, it was observed that the cytopenias of patient improved. To evaluate disease status, bone marrow aspiration biopsy, positron emission tomography (PET-CT) and flow cytometry were performed. PET CT, normal uptake of fluoro-2-deoxy-d-glucose (FDG) occurs in whole body and no characteristic hypermetabolic focus that could be compatible with malignancy was detected. PET CT revealed regression of mediastinal lymphadenopathies (Fig. 2b) In peripheral blood flow cytometry, proliferation of monotypic B lymphocytes which compatible with CLL, was not detected (Fig. 1b). Lymphocytosis and clinical presentations including lymphadenopathy, hepatomegaly and splenomegaly were not observed in the long-term follow-up of patient. leucocyte graph is shown in Fig. 2e.