Blood Res.  2020 Jun;55(2):123-127. 10.5045/br.2020.2020069.

Atypical presentation of hairy cell leukemia: a report and comprehensive review

• Pattnaik SA
• Padhi S
• Chhabra G
• Panigrahi MK
• Das PK
• Bhola RK
• Mishra S

• KMID: 2503490
• DOI: http://doi.org/10.5045/br.2020.2020069

Figure

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  Fig. 1 Spectrum of circulating lymphoid cells in the peripheral blood in this case. Note the absence of characteristic circumferential hair-like projections in most cells (Leishman Giemsa stain, ×400).

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  Fig. 2 Trephine marrow sections from the case demonstrating diffuse sheets of small mature-looking lymphoid cells with round to mildly irregular nuclear outlines and abundant clear cytoplasm with a ‘fried egg’ pattern classical of hairy cell leukemia (A, Hematoxylin and eosin, ×400). On immunohistochemistry, these lymphoid cells show strong diffuse positivity for CD20 (B), CD11c (not shown), and CD10 (C, peroxidase-antiperoxidase, ×400).

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  Fig. 3 Flow cytometric immunophenotyping plots with the population of interest (B cells) gated in red on CD19 versus side-scattered light (SSC). The B cells are positive for CD11c (bright), CD25 (bright), CD200, CD103, and CD123 diagnostic of hairy cell leukemia. Note the dim to moderate CD23 positivity in the CD19+ lymphoid cells as previously reported in the literature.

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