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Chronic lymphocytic leukaemia with upper airway obstruction

M G Dean1, I Cunningham, L P Dao

  • 1Department of Haematology, Concord Hospital, Sydney, Australia.

Leukemia & Lymphoma
|February 1, 1996
PubMed

Insights

A rare case of chronic lymphocytic leukemia presented with airway obstruction due to tonsil enlargement. Localized radiotherapy to Waldeyer's ring provided lasting relief from this obstruction.

Area of Science:

  • Hematology
  • Oncology
  • Otorhinolaryngology

Background:

  • B-cell chronic lymphocytic leukemia (CLL) is a common hematologic malignancy.
  • Airway obstruction is an uncommon but serious complication of CLL.
  • Enlargement of lymphoid tissues in Waldeyer's ring can lead to airway compromise.

Observation:

  • A 58-year-old female with CLL experienced severe upper airway obstruction.
  • Massive enlargement of palatine and lingual tonsils was identified as the cause.
  • Peripheral blood analysis confirmed CLL with typical immunophenotype (CD19+, CD20+, CD5+, CD23+, HLA-DR+).

Findings:

  • Surgical tonsillectomy and chemotherapy offered only temporary relief from obstruction.
  • Recurrence of obstruction at the lingual tonsils necessitated further intervention.
  • Localized radiotherapy to Waldeyer's ring achieved lasting resolution of the mass effect and obstruction.

Implications:

  • This case highlights an unusual presentation of CLL.
  • It underscores the importance of considering lymphoid hyperplasia in the differential diagnosis of airway obstruction.
  • Radiotherapy can be an effective treatment modality for refractory airway obstruction caused by lymphoid enlargement in CLL.

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