Patient Presentation

A 48-year-old man underwent health screening through his employer and was recommended to see his physician after preliminary test results. He has not had any sudden symptoms like fever or chills, nor has he experienced weight loss, but he has noticed increased fatigue over the past few months. He has no personal or family history of cancer and is not on any medications. His physical examination shows no abnormalities, with no enlargement of organs or detectable swollen lymph nodes.                     

Diagnostic Findings   

CBC showed WBC:297 X10^3/ µL,Hemoglobin/:10,7 g/dl and Platelet:74 X10^3/ µL.

Peripheral blood film showed Lymphocytosis with large atypical lymphocytes ,some lymphocytes have nucleoli, and increased smudge cells.Normocytic normochromic RBCs and reduced palatelets.

FISH revealed trisomy12 ,TP53 < 20%(deletion) and  IgH mutated.BIRC3 and FBXW7 detected In 9% allelic ratio.No 11q,13q,14q.

Final diagnosis

Chronic Lymphocytic Leukemia with trisomy 12