13 January 2017 (Friday) - Richter's Transformation

This case appeared on one of the Facebook groups I follow:

"I was on differential bench one day and saw a lot of smudges on the slide. WBC elevated, mostly lymphs, so I thought it's just another CLL. Looked into patient history Dx, CLL. Made an albumin slide, and noticed something a little bit unusual. Are you able to identify those cells? What do you think makes this case interesting? Answer will be revealed in a few days!
Great discussion!! So someone had the right answer.. 
This is a case of Richter's transformation, where CLL is transforming into lymphoma. Unfortunately I didn't follow up with which type of lymphoma it's transforming into, but those abnormal looking cells aside from the CLL lymphs are lymphoma cells indeed. 
Take home message.. Never treat a CLL albumin slide "just another CLL albumin slide"! "

Interesting... those cells aren't at all typical. But I'm lef wondering what's an "albumin slide" ?

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