title: Chronic lymphocytic leukemia presenting with ascites diagnosed by clonality analysis via gene rearrangement assay: A case report.
abstract: The diagnosis of chronic lymphocytic leukemia (CLL) presenting with ascites is predominantly based on the morphological and immunophenotypic characteristics, which are comparable to peripheral blood and bone marrow cells. However, it is relatively difficult to diagnose CLL due to the pleomorphism of the lymphocytes in ascites. The current study presents an 80-year-old male with a prior diagnosis of CLL who developed large ascites. Predominant T lymphocytes rendered morphological and immunophenotypic diagnosis difficult. Clonality analysis of immunoglobulin (Ig) gene rearrangements was performed on the lymphocytes from the ascites to diagnose the involvement of CLL, a laparotomy and biopsy from the peritoneal node confirmed the involvement of small lymphocytic lymphoma/CLL. The clonality analysis of Ig gene rearrangements may provide a powerful and accurate method for diagnosing CLL presenting with ascites.
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Chang Gung Memorial Hospital, Keelung, Taoyun 33305, Taiwan, R.O.C. ; Department of Internal Medicine, Division of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taoyun 33305, Taiwan, R.O.C.
authors.forename: Yen-Min
authors.initials: YM
authors.lastname: Huang
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taoyun 33305, Taiwan, R.O.C. ; School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, R.O.C.
authors.forename: Lee-Yung
authors.initials: LY
authors.lastname: Shih
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taoyun 33305, Taiwan, R.O.C. ; School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, R.O.C.
authors.forename: Po
authors.initials: P
authors.lastname: Dunn
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taoyun 33305, Taiwan, R.O.C. ; School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, R.O.C.
authors.forename: Po-Nan
authors.initials: PN
authors.lastname: Wang
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taoyun 33305, Taiwan, R.O.C. ; School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, R.O.C.
authors.forename: Ming-Chung
authors.initials: MC
authors.lastname: Kuo
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taoyun 33305, Taiwan, R.O.C. ; School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, R.O.C.
authors.forename: Jin-Hou
authors.initials: JH
authors.lastname: Wu
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taoyun 33305, Taiwan, R.O.C. ; School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, R.O.C.
authors.forename: Tung-Liang
authors.initials: TL
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taoyun 33305, Taiwan, R.O.C. ; School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, R.O.C.
authors.forename: Tzung-Chih
authors.initials: TC
authors.lastname: Tang
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taoyun 33305, Taiwan, R.O.C. ; School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, R.O.C.
authors.forename: Hung
authors.initials: H
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taoyun 33305, Taiwan, R.O.C. ; School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, R.O.C.
authors.forename: Hsiao-Wen
authors.initials: HW
authors.lastname: Kao
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taoyun 33305, Taiwan, R.O.C.
authors.forename: Hsuan-Jen
authors.initials: HJ
authors.lastname: Shih
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Chang Gung Memorial Hospital, Linkou, Taoyun 33305, Taiwan, R.O.C.
authors.forename: Yu-Shin
authors.initials: YS
authors.lastname: Hung
keywords: ascites; chronic lymphocytic leukemia; gene rearrangement