Hairy-Cell Leukemia Presenting As Lytic Bone Lesions

Gray, Madison T.; Rutherford, Michael N.; Bonin, Denis M.; Patterson, Bruce; López, Pedro

doi:10.1200/jco.2012.47.5301

Cited by 20 publications

(20 citation statements)

References 8 publications

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“…This series is a first of its kind in reporting a series of HCL cases without splenomegaly and highlighting the importance of diagnosing this condition even in the absence of one of its classical clinical feature namely splenomegaly. Some of the case reports of HCL without splenomegaly presented with lytic bony lesions [15,17], however none of the cases brought out in present series had any lytic bone lesions. The comparison provided in Table 1 shows the incidence of absence of splenomegaly in HCL cases.…”

Section: Discussionmentioning

confidence: 64%

“…Hairy cell leukemia can present without splenomegaly and so far there are individual case reports of HCL without splenomegaly [12][13][14][15][16][17][18]. This series is a first of its kind in reporting a series of HCL cases without splenomegaly and highlighting the importance of diagnosing this condition even in the absence of one of its classical clinical feature namely splenomegaly.…”

Section: Discussionmentioning

confidence: 93%

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Unusual Presentation of Hairy Cell Leukemia: A Case Series of Four Clinically Unsuspected Cases

Somasundaram

Purohit

Aggarwal

et al. 2014

Indian J Hematol Blood Transfus

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Hairy cell leukemia (HCL) is characterized by pancytopenia and usually associated with massive splenomegaly, however the same may not be true in the clinical settings. Here we report four cases of HCL and all of them were without the classical clinical feature of splenomegaly. This is an observational study conducted between January 2013 to March 2014 where we could diagnose ten cases of HCL in Department of Hematology, All India Institute of Medical Sciences, New Delhi. Of these, four cases attracted attention because of absence of classical clinical features of HCL. Of the four cases, three presented with weakness/fatigability while fourth patient presented with recurrent respiratory tract infection. Surprising finding in these cases was absence of splenomegaly, both clinically and on imaging which demerit the suspicion of HCL clinically. All four had bi/pancytopenia and bone marrow examination coupled with immunophenotypic analysis confirmed the diagnosis of HCL. Three patients received chemotherapy with cladribine and achieved complete hematological remission. One patient did not receive chemotherapy due to poor general condition and was subsequently lost to follow up. To conclude, HCL can and do present without splenomegaly and this should not restrain one from suspecting HCL based on histomorphology which needs to be further confirmed by ancillary techniques. This finding in our series could be because these cases were picked early in their natural course of the disease. A high index of suspicion is essential for diagnosing and appropriately managing such cases.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 93%

Unusual Presentation of Hairy Cell Leukemia: A Case Series of Four Clinically Unsuspected Cases

Somasundaram

Purohit

Aggarwal

et al. 2014

Indian J Hematol Blood Transfus

View full text Add to dashboard Cite

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“…Skeletal complications can occur as a consequence of HCL, with a reported incidence of 3% and presentation about 20 months after initial diagnosis, but to present with skeletal abnormalities is very rare (9). Lytic bone lesions at presentation have been infrequently reported, with only a small number of case reports noted (6,10). Th e lytic lesions usually involve the proximal femur (10).…”

Section: Discussionmentioning

confidence: 99%

“…Lytic bone lesions at presentation have been infrequently reported, with only a small number of case reports noted (6,10). Th e lytic lesions usually involve the proximal femur (10). Less frequent sites include the vertebrae, pelvis, humerus, skull, and distal tibia (10).…”

Section: Discussionmentioning

confidence: 99%