Acute myeloid leukemia arising in treated chronic lymphocytic leukemia/small lymphocytic lymphoma: a challenge in analysis of lineage relationship.
Aruna Rangan, Min Shi, Paul Ollila et al.
✦ AI-curated · Sources linked
Case in brief
A 75-year-old female with a history of chronic lymphocytic leukemia/small lymphocytic lymphoma, previously treated with obinutuzumab and venetoclax, presented with acute myeloid leukemia characterized by CD4+/CD56+/CD123+ markers and histiocytic morphology. Initial misdiagnosis suggested CLL transdifferentiation to histiocytic sarcoma, but further analysis confirmed de novo acute myeloid leukemia.
What made this case unusual
The case featured acute myeloid leukemia with histiocytic morphology, which initially led to confusion with histiocytic sarcoma, highlighting the complexity of lineage determination in post-therapy scenarios.
Diagnostic / clinical pearl
Clinicians should be aware of the potential for atypical presentations of acute myeloid leukemia in patients with a history of B-cell malignancies, necessitating thorough ancillary studies for accurate diagnosis.
Why it matters
This case emphasizes the importance of careful lineage analysis in patients with complex hematologic histories, as misdiagnosis can lead to inappropriate management strategies.