The definitive study for this patient is flow cytometry. It can easily separate CLL from ALL.
From the morphology only, I favor chronic lymphocytic leukemia. The cells are medium size with hyperchromatic nuclear, abundant cytoplasm and occasinal nucleoli. The dark chromatin in some cells and more cytoplasm are more suggestive of mature lymphoid cells. With this type morphology, the lymphoid cells are often CD5 negative. We will call this atypical CLL or CD5 negative CLL if the patient does not have an enlarged spleen. If there is a large spleen, this may represent a leukemic phase of splenic marginal zone lymphoma. 
 
讲解的真是太好了！