This bladder biopsy is from a 60 y/o female with a long-standing history of chronic lymphocytic leukemia. She presented with gross hematuria and was found to have two raised nodular areas in the dome of her bladder on cystoscopy. The biopsies show a dense infiltrate composed of small, uniform lymphocytes in the lamina propria. Immunostains for CD20 and CD5 were positive. This represents secondary involvement of urinary bladder in CLL.