Diagnostic burdens in patient with CLL/SLL in the primary care clinic - A case report

Introduction: Chronic lymphocytic leukemia (CLL) together with small lymphocytic lymphoma (SLL) are considered different manifestations of the same disease from the group of low-grade B-cell lymphomas.The diagnosis of each is made based on either a blood count or a lymph node biopsy.However, the diagnostic tools for evaluating lymphadenopathy in primary care are limited, which contributes to the diagnostic challenges in determining its underlying causes.Case Report: A 67-yearold woman reported to the general practitioner (GP) clinic due to an increase in the abdominal circumference over the past 2 weeks.Additionally, she noted recent mild enlargement of the lymph nodes in the submandibular and left axillary area.Physical examination revealed one small lymph node on the left submandibular side, and in the central region of the left axilla, two lymph nodes of about 10-15 mm in size.The results of blood tests revealed no abnormalities.The chest X-ray examination revealed suspicion of fluid in both pleural cavities.Finally, the ultrasound examination of the abdomen and breasts showed numerous enlarged lymph nodes.After the referral to a surgical oncology clinic, and SLL was initially diagnosed.Conclusion: Early recognition and understanding of the benign and malignant etiologies of lymphadenopathy play a critical role for prompt diagnosis and treatment initiation.