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An unusual B-cell lymphoma simulating hairy cell leukemia
1Department of Pathology, Beth Israel Hospital, Boston, Massachusetts 02215.
American Journal of Clinical Pathology
|December 1, 1987
Summary
This study describes a rare B-cell lymphoma mimicking hairy cell leukemia (HCL). Definitive diagnosis required spleen examination, highlighting the need for caution in diagnosing HCL solely from bone marrow.
Area of Science:
- Hematology
- Oncology
- Immunopathology
Background:
- Hairy cell leukemia (HCL) is a distinct B-cell malignancy with characteristic clinical and pathological features.
- Accurate diagnosis of lymphoid neoplasms is crucial for appropriate patient management and treatment strategies.
Observation:
- An unusual B-cell lymphoma presented with clinical and pathological findings mimicking HCL in peripheral blood, bone marrow, and lymph nodes.
- Morphological assessment suggested monocytoid B-cell lymphoma (MBCL), but immunophenotype and clinical presentation were more aligned with mantle zone lymphoma (MZL).
Findings:
- A definitive diagnosis of lymphoma was only established after pathological examination of the spleen.
- The lymphoma exhibited features overlapping both MBCL and MZL, including specific immunophenotypic markers (monoclonal Ig-kappa +, Ia+, B4+, Leu-1+, LN-2+, lambda-, Bl-, LN-1-, CALLA-).
Implications:
- This case underscores the importance of comprehensive pathological evaluation, including splenic examination, for diagnosing challenging lymphoid neoplasms.
- The overlapping features suggest a potential common histogenesis between MBCL and MZL, warranting further investigation into their relationship.