Solitary Lytic Bone Metastasis: A Rare Presentation of Small Lymphocytic Leukemia

Abstract EN

Chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) is a hematologic malignancy characterized by an over accumulation of incompetent neoplastic lymphocytes.

Bone metastasis in CLL/SLL is very rare.

We report a case of a 76-year-old Caucasian female presented with an unresolving pulmonary infiltrate with mediastinal lymphadenopathy concerning for malignancy.

Positron emission tomography (PET)/computed tomography (CT) showed an infiltrative mass in the mediastinum with diffuse uptake and a hypermetabolic mass within the left iliac bone.

Transbronchial biopsy revealed morphology and features of SLL.

However, with concern for another primary cancer, a CT-guided biopsy of the PET avid left iliac bone was performed and revealed bone and marrow with involvement of CLL/SLL similar to the chest lymphadenopathy.

To our knowledge and after extensive review of medical literature, this is first reported case of SLL with solitary bone metastasis to the hip.