Hematology Case 21
Presented By Dr Islam Mekawy
Released on 9-11-2019Patient Data
Female patient, 56 years old.
Clinical Data
The patient presented with shortness of breath, easy fatigue and abdominal distension.
Clinical examination revealed moderate splenomegaly and pallor.
Related Laboratory Results
Hemoglobin: 9.6 g/dl,
MCV: 72.3fL,
MCH: 24.4pg,
leucocytic count: 4,900/cmm ; Basophils:0%, Eosinophils:0%, Neutrophils:47%, Lymphocytes:49%, Monocytes:4%,
Platelet count: 175,000/cmm
Moderate microcytic hypochromic anemia, some lymphocytes show hairy cytoplasmic projections.
Case Picture(s) / Photo(s)
Comment / Findings
Some lymphocytes show hairy cytoplasmic projections.
Recommended for bone marrow aspiration / biopsy and immunophenotyping.
Dry tap for bone marrow aspirate, biopsy sections are normocellular for age with normal fat cell ratio, some areas are infiltrated by cells having the fried egg appearance, other areas show mild fibrosis, IHC was done on biopsy sections CD11c, CD103 and CD25 are positive.
Attached are pictures of hairy cells in peripheral blood and pictures of areas of infiltration by hairy cells in bone marrow biopsy
Final Diagnosis
Hairy cell leukemia classical type