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Clinical Features: B-cell prolymphocytic leukemia (B-PLL) is a disease of the elderly. Median age at diagnosis is 69 years. Patients usually present with B symptoms (fever, night sweats, and weight loss), massive splenomegaly and an elevated white blood cell count (usually > 100,000/μL). Peripheral lymphadenopathy may be seen in one-third of cases but is not prominent. Anemia and thrombocytopenia are present in 50% of cases.

Relapsing B-PLL can have atypical features, including central nervous system involvement, refractory hypercalcemia, and an intramuscular mass.

The image show B-PLL involving bone marrow.

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