An unusual presentation of Richter's transformation of chronic lymphocytic leukemia in liver and lung on18F-labeled fluoro-2-deoxyglucose positron emission tomography/computed tomography

Richter's transformation (RT) is a rare complication of chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) with unfavorable prognosis. The clinical and laboratory findings of RT are nonspecific and requires histopathological confirmation for the diagnosis.F-18-labeled fluoro-2-deoxyglucose positron-emission tomography/computed tomography (F-18-FDG PET/CT) has shown higher diagnostic values for the detection of transformation of CLL/SLL to aggressive lymphoma. We present a case of CLL in remission for 6 years presenting with clinical features suggestive of RT.F-18-FDG PET/CT done in our case showed liver and lung involvement with no lymphadenopathy, which is an unusual presentation of RT.