Abstract
Chronic lymphocytic leukemia (CLL) is a neoplasm composed of mature small B cells coexpressing CD5 and CD23. CLL has the potential to transform into an aggressive form of lymphoma, commonly diffuse large B-cell lymphoma. This transformation was first described in 1928 by Maurice Richter and has since been known as the Richter transformation. The Richter transformation has a poor prognosis. In cases of CLL with a Ki-67 proliferation index >40% and >2.4 mitoses in proliferation centers without true large cells have been determined to have a prognosis intermediate between CLL and Richter syndrome. We present an interesting case of a 42-year-old male presenting with high-grade chronic lymphocytic leukemia manifesting as multiple tumor nodules of his temple.
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