Biclonal B-Chronic Lymphocytic Leukemia: A rare Case Report with Review of Literature

Chronic Lymphocytic Leukemia/Small Lymphocytic Leukemia is a neoplasm composed of monomorphic small mature B cells that co-express CD5, CD23 and one type of immunoglobulin light chain either kappa or lambda, which is necessary for the diagnosis. Here, we report a case in a 65 year woman with morphological diagnosis of B-Chronic Lymphocytic Leukemia. On flowcytometry analysis, immunoglobulin light chain restriction was not apparent as B cells expressed both kappa & lambda light chains without a clear monotypic population. Sequential gating on flowcytometry revealed two monoclonal B-cell populations and helped in identification of this rare case of biclonal disease in chronic lymphocytic leukemia (CLL).