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Hairy Cells

Hairy Cells Letter to the Editor To the Editor:—It has been suggested gery a 1600 gm spleen was removed and Further investigation is necessary, but that typical cases of "hairy cell" leuke­ a conglomerated lymph node mass, lo­ decreased LAP levels may be associated mia (HCL) characteristically show high cated in the area of the celiac plexus and with an atypical form of HCL. In our levels of alkaline phosphatase in the cir­ splenic peduncle, was incompletely re­ case the disease showed a lymphoma- culating neutrophils. Furthermore, a sected. The diagnosis of HCL was con­ tous-like pattern with a minor marrow normal leukocyte alkaline phosphatase firmed by histologic study of the spleen, granulocyte reserve impairment. (LAP) score may be associated with a liver, lymph nodes, and bone marrow. chronic form of HCL requiring: little After splenectomy, there was normal­ ANTONIO CARBONE, M.D. therapy. ization of the hemoglobin, leukocyte, RACHELE VOLPE, M.D. Aiba and co-workers also supported and platelet counts. LAP levels re­ ENZO GALLIGIONI, M.D. these suggestions and stressed the rela­ mained markedly reduced. However, an UMBERTO TIRELLI, M.D. tionship between LAP levels and prog­ enlargement of cervical, axillary, and ANDREA VEROMESI, M.D. nosis in HCL; they believe that high lombo-aortic lymph nodes reappeared GAETANO TROVO, M.D. LAP levels are associated with decreased and remained unvaried until September SALVATORE TUMOLO, M.D. marrow granulocyte reserves. 1980, when an abdominal mass of the ELIGIO GRIGOLETTO, M.D. left upper quadrant was noticed. Che­ Decreased or absent LAP levels have motherapy (cyclophosphamide, doxo­ not been recorded for patient!; with References rubicin, vincristine, and prednisone) was HCL, except for the case of a patient in 1. Aiba M, Raffa PP, Katayama I: Signif­ administered and a complete clinical re­ whom extensive enzyme deficiencies, in­ icance of leukocyte alkaline phospha­ mission was achieved. The treatment tase in hairy cell leukemia. Am J Clin cluding LAP, were noticed. Unfortu­ was well tolerated. Pathol 74:297-300, 1980 nately, clinical details regarding the 2. Budman DR, Koziner B, Arlin Z, Lam- course of his disease were lacking. On June 19, 1981 the patient was well, pen N, Gee T: Massive lymphadenop­ We have recently observed a case of without evidence of lymphadenopathy athy mimicking lymphoma in leu­ kemic reticuloendotheliosis. Am J Med HCL with unusual clinical features oc­ and free of signs of infections. LAP lev­ 66:160-162, 1979 curring in a patient in whom LAP levels els were immodified. Hairy cells were 3. Golomb HM, Vardiman J, Variakojis D: were markedly reduced. present on peripheral blood and marrow Neutrophil alkaline phosphatase scores A 69-year-old female was admitted on smears accounting for 40% and 20% of in hairy cell leukemia: cytochemical, May 3, 1979 because of massive spleno­ all nucleated cells, respectively. functional, and clinical correlations. (Letter) Br J Haematol 43:156-157, megaly, generalized lymphadenopathies, It is known that non-Hodgkin's leukopenia, anemia, and thrombocyto­ lymphomas may occasionally simulate 4. Hayhoe FGJ, Flemans RJ, Burns GF, penia. Peripheral blood smears showed HCL. On the other hand, a patient with Cawley JC: Leukocyte alkaline phos­ neutropenia, with 30% atypical elements HCL in whom massive lymphadenopa­ phatase scores in hairy cell leukemia. exhibiting hair-like cytoplasmic projec­ thy mimicked a lymphoma has been re­ (Letter) Br J Haematol 37:158-159, tions. A tartrate-resistant acid phospha­ ported. In the present case microscop­ 5. Neiman RS, Sullivan AR, Jaffe R: Ma­ tase activity was present in mote than ical findings which are specific enough lignant lymphoma simulating leu­ 20% of these cells. Repeated LAP values for an accurate diagnosis of HCL were kemic reticuloendotheliosis. A clini- were always less than 10 (NR 10-100). associated with some atypical features. copathologic study of ten cases. Cancer Chromosome Ph analysis was negative. Massive and generalized lymphadeno­ 43:329-342, 1979 6. Zeya HI, Keku E, Richards FH, Spurr A tentative diagnosis of HCL was; given. pathies were present, and a well toler­ CL: Absence of neutral protease and ated chemotherapy produced a complete On June 14, 1979 the patient under­ alkaline phosphatase in neutrophils of remission of symptoms. LAP levels were went exploratory laparotomy with sple­ a case of hairy cell leukemia. Am J constantly decreased. nectomy and multiple biopsies. At sur­ Pathol 95:55-66, 1979 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Clinical Pathology Oxford University Press

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Publisher
Oxford University Press
Copyright
© American Society of Clinical Pathologists
ISSN
0002-9173
eISSN
1943-7722
DOI
10.1093/ajcp/76.5.728
Publisher site
See Article on Publisher Site

Abstract

Letter to the Editor To the Editor:—It has been suggested gery a 1600 gm spleen was removed and Further investigation is necessary, but that typical cases of "hairy cell" leuke­ a conglomerated lymph node mass, lo­ decreased LAP levels may be associated mia (HCL) characteristically show high cated in the area of the celiac plexus and with an atypical form of HCL. In our levels of alkaline phosphatase in the cir­ splenic peduncle, was incompletely re­ case the disease showed a lymphoma- culating neutrophils. Furthermore, a sected. The diagnosis of HCL was con­ tous-like pattern with a minor marrow normal leukocyte alkaline phosphatase firmed by histologic study of the spleen, granulocyte reserve impairment. (LAP) score may be associated with a liver, lymph nodes, and bone marrow. chronic form of HCL requiring: little After splenectomy, there was normal­ ANTONIO CARBONE, M.D. therapy. ization of the hemoglobin, leukocyte, RACHELE VOLPE, M.D. Aiba and co-workers also supported and platelet counts. LAP levels re­ ENZO GALLIGIONI, M.D. these suggestions and stressed the rela­ mained markedly reduced. However, an UMBERTO TIRELLI, M.D. tionship between LAP levels and prog­ enlargement of cervical, axillary, and ANDREA VEROMESI, M.D. nosis in HCL; they believe that high lombo-aortic lymph nodes reappeared GAETANO TROVO, M.D. LAP levels are associated with decreased and remained unvaried until September SALVATORE TUMOLO, M.D. marrow granulocyte reserves. 1980, when an abdominal mass of the ELIGIO GRIGOLETTO, M.D. left upper quadrant was noticed. Che­ Decreased or absent LAP levels have motherapy (cyclophosphamide, doxo­ not been recorded for patient!; with References rubicin, vincristine, and prednisone) was HCL, except for the case of a patient in 1. Aiba M, Raffa PP, Katayama I: Signif­ administered and a complete clinical re­ whom extensive enzyme deficiencies, in­ icance of leukocyte alkaline phospha­ mission was achieved. The treatment tase in hairy cell leukemia. Am J Clin cluding LAP, were noticed. Unfortu­ was well tolerated. Pathol 74:297-300, 1980 nately, clinical details regarding the 2. Budman DR, Koziner B, Arlin Z, Lam- course of his disease were lacking. On June 19, 1981 the patient was well, pen N, Gee T: Massive lymphadenop­ We have recently observed a case of without evidence of lymphadenopathy athy mimicking lymphoma in leu­ kemic reticuloendotheliosis. Am J Med HCL with unusual clinical features oc­ and free of signs of infections. LAP lev­ 66:160-162, 1979 curring in a patient in whom LAP levels els were immodified. Hairy cells were 3. Golomb HM, Vardiman J, Variakojis D: were markedly reduced. present on peripheral blood and marrow Neutrophil alkaline phosphatase scores A 69-year-old female was admitted on smears accounting for 40% and 20% of in hairy cell leukemia: cytochemical, May 3, 1979 because of massive spleno­ all nucleated cells, respectively. functional, and clinical correlations. (Letter) Br J Haematol 43:156-157, megaly, generalized lymphadenopathies, It is known that non-Hodgkin's leukopenia, anemia, and thrombocyto­ lymphomas may occasionally simulate 4. Hayhoe FGJ, Flemans RJ, Burns GF, penia. Peripheral blood smears showed HCL. On the other hand, a patient with Cawley JC: Leukocyte alkaline phos­ neutropenia, with 30% atypical elements HCL in whom massive lymphadenopa­ phatase scores in hairy cell leukemia. exhibiting hair-like cytoplasmic projec­ thy mimicked a lymphoma has been re­ (Letter) Br J Haematol 37:158-159, tions. A tartrate-resistant acid phospha­ ported. In the present case microscop­ 5. Neiman RS, Sullivan AR, Jaffe R: Ma­ tase activity was present in mote than ical findings which are specific enough lignant lymphoma simulating leu­ 20% of these cells. Repeated LAP values for an accurate diagnosis of HCL were kemic reticuloendotheliosis. A clini- were always less than 10 (NR 10-100). associated with some atypical features. copathologic study of ten cases. Cancer Chromosome Ph analysis was negative. Massive and generalized lymphadeno­ 43:329-342, 1979 6. Zeya HI, Keku E, Richards FH, Spurr A tentative diagnosis of HCL was; given. pathies were present, and a well toler­ CL: Absence of neutral protease and ated chemotherapy produced a complete On June 14, 1979 the patient under­ alkaline phosphatase in neutrophils of remission of symptoms. LAP levels were went exploratory laparotomy with sple­ a case of hairy cell leukemia. Am J constantly decreased. nectomy and multiple biopsies. At sur­ Pathol 95:55-66, 1979

Journal

American Journal of Clinical PathologyOxford University Press

Published: Nov 1, 1981

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