Pathological Puzzles: CLL-B Unraveled in Gastrointestinal Exploration
Miguel Martins, Joana Mota, Hélder Cardoso, Guilherme Macedo
Serviço Gastrenterologia, Centro Hospitalar Universitário São João / ULS São João
DESCRIPTION
A 54-year-old male with non-bloody diarrhea underwent upper and lower endoscopic evaluation, revealing a 30-mm gastric fundus lesion (Paris IIa + IIc) and diffuse abnormalities in the duodenum, ileum, and right colon. Gastric biopsies exhibited distinctive cellular characteristics, including small lymphocytes and larger cells with irregular nuclei. Immunohistochemistry indicated CD20 and PAX5 positivity, with equivocal Bcl-2 expression; some cells expressed Bcl-6. Additional biopsies showed nodular lymphoid hyperplasia. Diagnosed with Chronic Lymphocytic Leukemia (CLL-B) involving significant nodes, the case emphasizes the need for thorough investigation and advanced diagnostic techniques in uncovering complex gastrointestinal pathologies, contributing to medical knowledge.Figure 1
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