Clinical features

• Any age group; median age at diagnosis 55 years.

• Asymptomatic, modest lymphocytosis with large granular lymphocytes 186 on routine FBC.

• Occasional presentation with fatigue or recurrent bacterial infections.

• Arthralgia, itching, rash (25%), mouth ulcers; association with seropositive rheumatoid arthritis in 20% and Felty's syndrome (neutropenia + splenomegaly + rheumatoid arthritis).

• Splenomegaly recorded in 50-80% cases. Lymphadenopathy rare.

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