[Clinical evolution of chronic lymphocytic leukemia in Richter's syndrome]

Over a few year period chronic lymphocytic leukemia (CLL) is mainly characterized by stable course and only in the small per cent of patients it evolves into the aggressive form. Richter's syndrome has been diagnosed at our clinic in a patient who was for 6 years controlled and treated for CLL. In that period the patient was doing well and the out-patient treatment of CLL was being performed together with regular check-ups according to hematologic findings and clinical status of the patient. The patient was capable of work. Clinical investigation was undertaken because of the sudden aggravation of the general state and x-ray of the chest which pointed to the existence of tumorous shadow in the right lower pole of hilus. Although a complete CLL remission was established cytologic diagnosis of the newly formed tumour pointed to non-Hodgkin lymphoma of high malignity (centroblast lymphoma). Course of disease was terminated lethally very soon, because lymphoma of high malignity did not respond to polychemotherapy.