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CLL primarily involves peripheral blood, spleen, and lymph nodes, whereas SLL predominantly affects lymph nodes. Patients with CLL\/SLL are at increased risk of developing second primary malignancies, including lung cancer, highlighting the need for ongoing surveillance. We report the case of an 83-year-old man with a history of CLL\/SLL who developed pulmonary adenocarcinoma. He presented weight loss and constitutional symptoms; imaging revealed retroperitoneal and mesenteric lymph node conglomerates along with a lung lesion. Histopathology confirmed SLL in the lymph nodes and primary mucinous adenocarcinoma of the lung. Evidence shows a heightened risk of second primary neoplasms in CLL\/SLL, particularly among patients exposed to alkylating agents. This case emphasizes the role of demographic and treatment-related factors\u2014such as male sex, advanced age, smoking history, and therapeutic regimens\u2014in secondary cancer development. Vigilant monitoring and a multidisciplinary approach tailored to individual risk are essential for early detection and optimal management in this population.<\/jats:p>","DOI":"10.1177\/23247096261440366","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T15:18:12Z","timestamp":1778771892000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary Lung Adenocarcinoma as a Second Neoplasm Following Chronic Lymphocytic Leukemia: A Case Report"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0789-9154","authenticated-orcid":false,"given":"Liliana","family":"Fern\u00e1ndez-Trujillo","sequence":"first","affiliation":[{"name":"Fundaci\u00f3n Valle del Lili"},{"name":"Universidad Icesi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luz F.","family":"Sua","sequence":"additional","affiliation":[{"name":"Universidad Icesi"},{"name":"Fundaci\u00f3n Valle del Lili"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan P.","family":"Mu\u00f1oz-Manzano","sequence":"additional","affiliation":[{"name":"Universidad del Valle"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciro D.","family":"Ibarra-Enriquez","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Valle del Lili"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan C.","family":"Bravo","sequence":"additional","affiliation":[{"name":"Universidad Icesi"},{"name":"Fundaci\u00f3n Valle del Lili"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"e_1_3_6_2_2","volume-title":"WHO Classification of Tumours Editorial Board. 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