Rare case of Richter's syndrome localization in liver and thyroid of a patient with a chronic lymphocytic leukemia (CLL) - Case report and literature

Ann Agric Environ Med. 2020 Mar 17;27(1):160-164. doi: 10.26444/aaem/106041. Epub 2019 Apr 9.

Abstract

Richter's syndrome (RS) is a rare complication in which chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL) transforms into a more aggressive type of lymphoma - diffuse large B cell lymphoma (DLBCL), or Hodgkin's lymphoma (HL). The review describes the clinical case of a patient with CLL and RS diagnosis. A computed tomography (CT) scan of the abdominal cavity detected numerous normodense areas in the liver. Simultaneously, ultrasound examination (USG) of the thyroid revealed the presence of a solid hypoechogenic lump. The material sampled from closed biopsies of liver and thyroid in both cases allowed the diagnosis of diffuse large B cell lymphoma (DLBCL). The liver and the thyroid are particularly rare locations of RS. However, those cases allowed the conclusion that RS may occur even in a very unexpected and less probable location.

Keywords: Richter’s syndrome; chronic lymphocytic leukemia; liver; thyroid.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis*
  • Leukemia, Lymphocytic, Chronic, B-Cell / pathology
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / pathology*
  • Lymphoma, Large B-Cell, Diffuse / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Middle Aged
  • Thyroid Neoplasms / diagnostic imaging
  • Thyroid Neoplasms / pathology*
  • Tomography, X-Ray Computed
  • Ultrasonography