Presentation
Evaluation for lymph nodes.
Patient Data
There are multiple enlarged lymph nodes, bilaterally: neck node levels Ib, IIa, IIb, III, IV and V are involved.
There is positive mass effect on both common carotid arteries with medial displacement.
No fluid collections are seen.
Station 2R, 4R, 7 and 8 mediastinal node enlargement with ill-defined borders.
Bilateral enlarged axillary nodes without necrosis or abscess.
There are no pulmonary infiltrates or pleural effusions.
There is a prominent liver without masses or abscess.
Enlarged retroperitoneal lymph nodes are seen in the para-aortic, interaortocaval, precaval and paracaval regions with positive mass effect on the right kidney and pancreas.
Mesenteric and pelvic confluent masses, compatible with enlarged lymph nodes.
Bilateral inguinal adenopathy is also present.
Secondary to compression there is pear-shaped bladder.
Case Discussion
The patient has a known history of diagnosed chronic lymphocytic leukemia (Binet stage B).
This type of leukemia is considered the most common type, it primarily affects adults around 65-70 years old.
The diagnosis is made through blood workup but characterization of size and distribution of lymphadenopathy, and splenomegaly or hepatomegaly is important for staging.
Binet stage B is characterized by three or more areas of enlarged lymph nodes, especially in the inguinal and axillary regions with no anemia or thrombocytopenia associated.
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