Introduction: Chronic lymphocytic leukemia (CLL) together with small lymphocytic
lymphoma (SLL) are considered different manifestations of the same disease from
the group of low-grade B-cell lymphomas. The diagnosis of each is made based on
either a blood count or a lymph node biopsy. However, the diagnostic tools for
evaluating lymphadenopathy in primary care are limited, which contributes to the
diagnostic challenges in determining its underlying causes. Case Report: A 67-yearold
woman reported to the general practitioner (GP) clinic due to an increase in the
abdominal circumference over the past 2 weeks. Additionally, she noted recent mild
enlargement of the lymph nodes in the submandibular and left axillary area.
Physical examination revealed one small lymph node on the left submandibular
side, and in the central region of the left axilla, two lymph nodes of about 10-15 mm
in size. The results of blood tests revealed no abnormalities. The chest X-ray
examination revealed suspicion of fluid in both pleural cavities. Finally, the
ultrasound examination of the abdomen and breasts showed numerous enlarged
lymph nodes. After the referral to a surgical oncology clinic, and SLL was initially
diagnosed. Conclusion: Early recognition and understanding of the benign and
malignant etiologies of lymphadenopathy play a critical role for prompt diagnosis
and treatment initiation.
Keywords: CLL/SLL, diagnostic, primary care
