Lung Metastasis From Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is a mature B-cell neoplasm diagnosed through blood counts, differential counts, blood smear, and immunophenotyping, and it can have a highly variable clinical presentation and course. In a 66-year-old man with a history of CLL, multiple pulmonary nodules were identified on a routine low-dose computed tomographic scan for lung cancer screening for his smoking history. Follow-up positron emission tomography with computed tomography showed indeterminate, low-level avidity nodules, prompting a right lower lobe wedge resection by video-assisted thoracoscopy for tissue diagnosis. Histologic examination displayed a sharply demarcated nodular infiltrate of small lymphocytes with coarse chromatin. Flow cytometry revealed a kappa light-chain-restricted CD19⁺ population of B cells coexpressing CD5 and CD23. Staining showed negative cyclin D1. This represents a rare case of CLL with lung metastasis.