Case Presentation
A 51-year-old male patient presented with skin masses, 10cm X 5 cm (figure 1), in May 2019. Biopsy showed Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL): diffuse infiltration by small lymphocytes with the immunophenotype(IF) of CD5+, CD23+, CD79a+>CD20+. Ki67% expression was 70%. Mild lymphocytosis (lymphocytes=13910/mm3) and lymphadenopathy without splenomegaly/hepatomegaly in computed tomography(CT) scans were also present. CLL was IgVH unmutated and deletion 17p/TP53 mutations were negative. The patient was treated with the novel time-limited combination of Venetoclax/Obinutuzumab1 from July 2019 until July 2020. The CLL skin component responded impressively (figure 2 and figure 3). Complete remission in CT scans and bone marrow biopsy was confirmed at the end of treatment. Undetectable CLL minimal residual disease in peripheral blood and bone marrow by 8-colour flow cytometry was also confirmed. CLL skin involvement is a rare clinical presentation especially at diagnosis. Ki67>45% is associated with more aggressive biology of Non-Hodgkin lymphomas2. Our case indicates that the novel time-limited treatment with the Venetoclax /Obinutuzumab combination can eradicate the CLL disease, even with unusual and biologically aggressive presentations.