Chronic lymphocytic leukemia(CLL) is a hematologic neoplasm characterized by
proliferation and accumulation of mature-appearing lymphocytes. In most cases, a single
clone of B lymphocytes undergoes malignant transformation, but a small proportion of
case involves monoclonal T lymphocytes. CLL is the most commonly occurring leukemia
in North America and Europe, but it is extremely rare in Orient. We reported the
second case of CD4+ CLL in Korea, who was a 52-year-old female with a
painful neck mass on admission.
CD4+ CLL was confirmed by bone marrow study and
immunophenotyping of lymphocytes. Peripheral blood smear showed markedly increased
number of lymphocytes and many smudge cells. Most of the lymphocytes were
mature-looking, which had leukemic nature. On bone marrow aspiration, marrow
elements were occupied with small mature lymphocytes, biopsy sections disclosed
slightly hypercellular marrow(70%) replaced by the small lymphocytes. Acid phosphatase
and alpha naphthyl acetate esterase of cells were positive. Surface marker study of
lymphocytes revealed SmIg; 1%, E-rosette; 71%, CD3; 96%, CD4; 92% and CD8; 2%,
respectively.

Keywords: CD4⁺, Chronic lymphocytic leukemia