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Richter's syndrome: report of a case.

A 42-year-old male presented with generalized massive lymphadenopathy, fever, weight loss and numerous cutaneous nodules. Peripheral blood examination showed lymphocytosis with small lymphocytes, and immunophenotyping revealed B-cell chronic lymphocytic leukemia (CLL). Cytogenetic analysis of bone marrow aspirate revealed a clonal abnormality of chromosome 11. Lymph node biopsies showed a B-immunoblastic lymphoma. A diagnosis of Richter's syndrome (RS) was made. The patient did not respond to doxorubicin, cyclophosphamide, vincristine and prednisolone (CHOP) and died of progressive disease with pneumonia and respiratory failure 9 months later. CLL is not common among Chinese people and RS is extremely rare.