**Core Concept**
Chronic Lymphocytic Leukemia (CLL) is a type of cancer characterized by the clonal proliferation of mature lymphocytes in the bone marrow and peripheral blood. CLL is distinct from acute leukemias due to its slow progression and indolent nature.
**Why the Correct Answer is Right**
Option b) Diagnosed in routine blood test is correct because CLL is often incidentally discovered during a routine complete blood count (CBC) or blood smear examination, which may reveal an abnormal increase in lymphocytes. This is a common presentation of CLL, as patients may be asymptomatic for a long period. Option c) Leukocytosis is also correct, as CLL is characterized by an elevated white blood cell count, specifically an increase in lymphocytes.
**Why Each Wrong Option is Incorrect**
**Option A:** "Can present as acute leukemia" is incorrect because CLL typically presents as a chronic or indolent disease, not as an acute leukemia. CLL cells are mature and do not exhibit the same level of blast cell infiltration seen in acute leukemias.
**Option D:** "More T lymphocytes seen" is incorrect because CLL is primarily characterized by an increase in B lymphocytes, not T lymphocytes. The majority of CLL cases involve a clonal expansion of mature B cells.
**Clinical Pearl / High-Yield Fact**
It's essential to remember that CLL can be asymptomatic for a long period, and diagnosis often occurs incidentally during a routine blood test. A high index of suspicion and awareness of CLL's typical presentation can lead to earlier diagnosis and appropriate management.
**Correct Answer:**
β Correct Answer: A. bc
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