Granulomas of spleen and liver in hairy cell leukaemia

In 15 patients with hairy cell leukaemia splenic epithelioid granulomas were demonstrated in 4 out of 13 investigated cases (31%) and liver granulomas in 2 out of 10 cases (20%). Granulomas were never found in bone marrow specimens. Histological stains for mycobacteria, fungi and bacteria failed to demonstrate an etiological agents and culture (sputum) for mycobacteria were only performed in 3 cases, 1 showing Mycobacterium Tuberculosis. Attention to the possible role of atypical mycobacterial infections as an explanation to the often reported unresponsive fever of unknown origin in hairy cell leukaemia and the use of lymph node and/or liver biopsies for culture as well as histology is recommended.