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Hairy cell leukemia presenting as localized skeletal involvement.
A Lal1, M S Tallman, M B Soble
1Department of Pathology, Northwestern University Medical School, Feinberg Pavilion 7-209C, 251 E Huron Street, Chicago, IL 60611, USA.
Leukemia & Lymphoma
|January 21, 2003
Summary
Hairy cell leukemia (HCL) can initially present as localized bone lesions without typical blood abnormalities. This case highlights HCL
Area of Science:
- Hematology
- Oncology
- Radiology
Background:
- Hairy cell leukemia (HCL) is a rare B-cell malignancy.
- Typically, HCL involves the spleen and bone marrow, with characteristic peripheral blood findings.
- Skeletal involvement is an uncommon initial presentation.
Observation:
- A 45-year-old man presented with isolated left thigh pain.
- Initial radiographs were normal.
- MRI revealed a marrow-based lesion in the left femur and trochanters.
Findings:
- Histological and immunophenotypic analysis confirmed a focal infiltrate of HCL.
- The patient had no abnormal peripheral blood counts or splenomegaly.
- Bone marrow biopsy did not show HCL involvement.
Implications:
- This case underscores that localized skeletal lesions can be the primary manifestation of HCL.
- HCL should be considered in the differential diagnosis of bone marrow lesions, even without overt hematologic signs.
- Radiologists and oncologists should consider HCL in cases of unexplained bone lesions.