Intracellular Crystals in Chronic Lymphocytic Leukemia

Interesting Images Intracellular Crystals in Chronic Lymphocytic Leukemia Sarvari Yellapragada and Perumal Thiagarajan * Department of Pathology and Medicine, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX 77030, USA * Correspondence: [email protected] Received: 2 December 2024; Accepted: 9 January 2025; Published: 1 March 2025 Abstract: An 81-year-old man presented with weight loss and lymphocytosis with a white blood cell count of 55,000/µL with 80% lymphocytosis and 20% segmented neutrophils. Hemoglobin was 14 g/dL and platelets 139 × 103/µL. In flowcytometric analysis of peripheral blood, the CD19-expressing lymphocytes (52%) were positive for CD5, CD23, and CD200 and they were negative for CD10, CD103, CD25, and T-cell markers. There was no surface expression of light chains. Serum protein electrophoresis revealed mild hypogammaglobulinemia (0.60 g/dL, normal >0.69) and on immunofixation electrophoresis there was a small monoclonal spike of IgG Lambda.