PubMed1984
Tumor progression associated with chronic lympholeukemia is an extreme rarity. The clinico-morphological types of malignant transformation include Richter's syndrome marked by a dramatic increase of the size of one or several lymph nodes, spleen, appearance of extranodal tumors, fever, the signs of intoxication, frequent reduction in the blood leukocyte count or hemogram normalization. Biopsy specimens of neoplasms show cells uncommon to the typical version of chronic lympholeukemia (blasts, histiocytes, and so forth). In rarely occurring "prolymphocytoid" transformation in the phase of marked progression of CLL as shown by the hemogram, the myelogram demonstrates a great number of prolymphocytes of the monoclonal origin with small lymphocytes of the chronic phase. During transformation according to the lymphoblastic type (two case reports described in the literature), the blasts showed the phenotype of small lymphocytes. Early diagnosis of tumor progression in CLL requires that the treatment be carried out according to the protocols for lymphosarcomas.