Tonsillar Hypertrophy in Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma: A Mini-Review
Bibliographic record
Abstract
Chronic lymphocytic leukemia (CLL) is a prevalent adult B-cell malignancy that primarily affects individuals over the age of 65. It is characterized by the accumulation of mature B lymphocytes in the blood and bone marrow, whereas small lymphocytic lymphoma (SLL) primarily involves the lymph nodes and lymphoid tissues, with minimal lymphocytosis in the blood. Both CLL and SLL are recognized as a single entity according to iwCLL guidelines. Tonsillar hypertrophy is a rare presentation of CLL and often an overlooked complication. We searched PubMed, Scopus, Semantic Scholar, and Google Scholar up to November 8, 2025, for patients with CLL or SLL and tonsillar enlargement. We identified 14 published cases of CLL/SLL with tonsillar enlargement. The review aims to highlight clinical features, diagnostic challenges, and outcomes. Most patients presented with dysphagia, airway obstruction, or obstructive sleep apnea. Diagnosis frequently required tonsillectomy, followed by histopathology, flow cytometry, and fluorescence in situ hybridization. Management strategies included observation, tonsillectomy for symptom relief and diagnosis, systemic chemoimmunotherapy, or targeted agents such as BTK inhibitors. Most patients achieved remission or symptom improvement; however, a few cases resulted in death due to rapidly progressive disease. This review highlights the importance of considering CLL in adults with unexplained tonsillar hypertrophy. Prompt biopsy, preferably with tonsillectomy and multidisciplinary evaluation, is essential to distinguish this rare entity from other conditions and to guide timely treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".