A 74-year-old man with a known diagnosis of chronic lymphocytic leukemia (CLL), receiving chlorambucil therapy, presented with rapidly progressive enlargement of lymph nodes 10 months after the initial diagnosis. Complete blood count revealed bicytopenia with marked leukocytosis (total leukocyte count: 76,000/cumm). PET-CT demonstrated increased FDG uptake in multiple lymph nodes both above and below the diaphragm, as well as involvement of the spleen and tonsils.