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[Hairy-cell leukemia with osteolytic bone changes]

K Rhyner, R Streuli, G S Kistler

    Schweizerische Medizinische Wochenschrift
    |June 25, 1977
    PubMed
    Summary
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    Hairy-cell leukemia can cause severe bone lesions, including fractures and osteolytic lesions, years after diagnosis and splenectomy. These findings suggest hairy cells are leukemic B-lymphocytes with potential to damage bone.

    Area of Science:

    • Hematology
    • Oncology
    • Pathology

    Background:

    • Hairy-cell leukemia (HCL) is a rare B-cell chronic lymphoid leukemia.
    • Bone involvement in HCL is uncommon but can manifest as osteolytic lesions.

    Observation:

    • Three patients with HCL developed spontaneous bone fractures and osteolytic lesions 1-3 years post-diagnosis and splenectomy.
    • Bone biopsies revealed medullary osteopathy with infiltration by hairy cells, reticulum cells, and plasmocytes.
    • Ultrastructural analysis confirmed the presence of typical hairy cells, some with ribosome-lamella complexes.

    Findings:

    • Hairy-cell leukemia is associated with significant bone pathology, including osteolytic lesions.
    • The cellular infiltrates in bone share features with those seen in plasmacytoma.

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  • Hairy cells exhibit characteristics of leukemic B-lymphocytes.

    • Implications:

    • HCL should be considered in patients presenting with unexplained bone lesions.
    • Further research into the mechanisms of bone destruction in HCL is warranted.
    • Understanding the B-lymphocyte properties of hairy cells may inform targeted therapies.