A Case Report of Hairy Cell Leukemia Presenting Concomitantly with Sweet Syndrome

Abstract

Hairy cell leukemia and Sweet syndrome are both uncommon hematological diagnoses. We present a patient who was admitted with fevers, pancytopenia, pneumonia, and rash. Diagnostic bone marrow biopsy demonstrates Hairy cell Leukemia and skin biopsy demonstrates neutrophils infiltration consistent with Sweet syndrome. The patient was treated with purine analogs with resolution of the cytopenias, infection, and rash.

Hairy Cell Leukemia Masquerading as Pancytopenia in Pregnancy

“…This patient's presentation is unusual in its association of a vesicular eruption consistent with bullous Sweet's syndrome with HCL. Sweet's syndrome is a neutrophilic dermatosis with a known association with hematological malignancies particularly acute myeloid leukemia [10] but rarely associated with HCL [11–13]. Consistent with another case, the patient's rash in this case resolved following chemotherapy [13].…”

Massive Splenomegaly and Pancytopenia: It’s a Hairy Situation

“…To our knowledge, only a small handful of case reports in recent literature have commented on a rash associated with HCL at presentation and prior to diagnosis. Two articles reported a leukocytoclastic/lymphocytic vasculitic rash, while one reported concomitant Sweet syndrome [ 13 - 15 ]. One study from 1984 reviewed cutaneous findings associated with HCL in 113 patients.…”

Image Gallery: Hairy‐cell leukaemia presenting with Sweet syndrome

“…(c, d) Skin biopsy was notable for dense neutrophilia and dermal oedema, consistent with Sweet syndrome. Bone marrow biopsy and flow cytometry were consistent with hairy‐cell leukaemia, which constitutes only 2% of all leukaemias . Treatment with cladribine and prednisone resulted in improved cell counts and resolution of the rarely observed hairy‐cell leukaemia‐associated Sweet syndrome …”