title: Colposcopic and cytologic detection of chronic lymphocytic leukemia in the vagina: a case report.
abstract: BACKGROUND
  Chronic lymphocytic leukemia (CLL) is one of the chronic lymphoproliferative disorders. CLL has a wide range of physical findings at the time of initial discovery, with lymphadenopathy being the most common. We report the first case of primary presentation of CLL of the vaginal cuff in an asymptomatic patient.
  
  
  METHODS
  A 68-year-old, white woman status post-total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis 25 years earlier, was referred for colposcopic evaluation of low-grade squamous intraepithelial lesion of the vagina. Pathologic examination, immunohistochemical studies, and immunoglobulin gene rearrangement studies of the biopsy specimens were performed. All of these findings were supportive of a diagnosis of CLL.
  
  
  CONCLUSIONS
  CLL in the vagina may present as an asymptomatic lesion. Hematologic malignancies should be considered in the differential diagnosis during workup of abnormal vaginal cytology.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. marina.katsnelson@gmail.com
authors.forename: Marina
authors.initials: M
authors.lastname: Katsnelson
authors.forename: Raeph
authors.initials: R
authors.lastname: Laughingwell
authors.forename: Lewis J
authors.initials: LJ
authors.lastname: Rose
authors.forename: Norman G
authors.initials: NG
authors.lastname: Rosenblum
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000473:pathology; D014621:Vagina / Q000473:pathology*; D014625:Vaginal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis