Infectious lymphadenitis in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma: a rare, but important, complication

Abstract

The differential diagnosis of rapidly progressive or symptomatic lymphadenopathy in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) includes infectious lymphadenitis. We studied 286 (9%) of 3040 patients with CLL seen between 2003 and 2012 at Mayo Clinic Rochester who had 356 diagnostic lymph node biopsies to evaluate rapidly progressive or symptomatic lymphadenopathy. Most (85.4%) biopsies showed progressive CLL, 8.9% a second lymphoid malignancy, 3.9% infectious lymphadenitis, 1.1% reactive adenitis and 0.6% non-hematological malignancies. Of the 12 patients (14 biopsies) with infectious lymphadenitis, five patients had never been treated for their CLL, and seven had a specific microbiological diagnosis (herpes simplex n = 3, Cryptococcus neoformans n = 1, Mycobacterium n = 1, coagulase negative Staphylococcus n = 2). We conclude that infectious lymphadenitis is a rare complication of CLL with clinical characteristics similar to progressive CLL and transformation to a more aggressive lymphoma. Early recognition and antimicrobial therapy treatment of infectious lymphadenitis can be highly effective in these patients.

Keywords::

• Chronic lymphocytic leukemia
• small lymphocytic lymphoma
• CLL
• lymphadenopathy
• infection
• lymphadenitis
• Cryptococcus
• Mycobacterium avium
• herpes simplex

Acknowledgement

Funding for this study was provided in part by the Predolin Foundation.

Potential conflict of interest

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