title: Bilateral Tonsillar Enlargement as a First Manifestation of Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma with an Unusual Interfollicular Pattern of Infiltration.
abstract: Tonsillar lymphoma usually presents as unilateral or bilateral enlargement or as an ulcerative or fungating lesions. Most lymphomas that involve the tonsils are diffuse large B-cell lymphomas and primary low grade lymphomas are exceptional. We report a case of primary B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) affecting tonsils with interfollicular pattern of infiltration in a 54-year-old female who clinically presented with bilateral tonsillar enlargement, sore throat, dysphagia and respiratory difficulty, unresponsive to the conservative treatment. To the best of our knowledge, till date only six cases of CLL/SLL infiltrating tonsils have been reported in the English literature, three of these were known cases of CLL/SLL prior to tonsillectomy. In the present case diagnosis of CLL/SLL was first time established on tonsillar histomorphology and that too with an unusual interfollicular pattern of infiltration.
authors.affiliation: Department of Pathology and Lab Medicine, Medanta-The Medicity Hospital, Sector-38, Gurgaon, 122001 India ; B-13/C MIG DDA Flats, Vatika Apartments, Mayapuri, New Delhi, 110064 India.
authors.forename: Rajan
authors.initials: R
authors.lastname: Duggal
authors.affiliation: Department of Pathology and Lab Medicine, Medanta-The Medicity Hospital, Sector-38, Gurgaon, 122001 India.
authors.forename: Alka
authors.initials: A
authors.lastname: Rana
authors.affiliation: Department of Medical Oncology and Haematology, Medanta-The Medicity Hospital, Sector-38, Gurgaon, 122001 India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Vaid
authors.affiliation: Department of Medical Oncology and Haematology, Medanta-The Medicity Hospital, Sector-38, Gurgaon, 122001 India.
authors.forename: Nitin
authors.initials: N
authors.lastname: Sood
authors.affiliation: Department of ENT and Head Neck Surgery, Medanta-The Medicity Hospital, Sector-38, Gurgaon, 122001 India.
authors.forename: Kumud Kumar
authors.initials: KK
authors.lastname: Handa
keywords: Chronic lymphocytic leukemia; Interfollicular; Tonsils