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Secondary Lymphoid Tissues ›› Spleen ›› Abnormal

Hairy Cell Leukemia

Hairy Cell Leukemia
Hairy Cell Leukemia
Hairy Cell Leukemia

Microscopic Features:

  • Peripheral blood smear shows abnormal intermediate-sized lymphocytes with hair-like cytoplasmic projections
  • Prominent nucleolus

Normal % blood-PB, marrow-BM, lymphoid tissue-LN:

  • PB: None
  • BM: None
  • LN: None

May Resemble:

Differential Diagnoses:

Splenic Marginal Zone Lymphoma
Reactive Lymphocytosis
CLL

Classic Immunophenotype:

  • CD19+
  • CD20+
  • CD5-
  • CD10-
  • CD103+
  • CD11c+
  • CD25+
  • Annexin1+

Cartoon Image:

Hairy Cell Leukemia cartoon
Click and dragRed blood cell for scalefor direct comparison

Misc:

Splenomegaly, Pancytopenia (many with monocytopenia), and dry aspirate during biopsy (due to marrow fibrosis) are common findings

The neoplastic cells typically involve the red pulp area of the spleen (as opposed to Splenic Marginal Zone Lymphoma which involves the white pulp)