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HORIBA Chase the Case #36 - Hairy Cell Leukemia
A 53-year-old patient diagnosed with Hairy Cell Leukemia (HCL). The case is provided by a laboratory in India.
September 2024 (PDF for print)
Patient Demography: Male aged 53 years
Symptoms: Atypical presentation of leg swelling since a week
Diagnosis: Hairy Cell Leukemia (HCL)
Microscopy: Lymphocyte-57%, Atypical lymphocyte-30% with hairlike projections, Monocyte-1%, Neutrophil-10%, Eosinophil-2%.
Other Tests: Immunophenotyping of these atypical hairy-like lymphocyte cells stained positive for CD45, CD19, CD20, CD11c, CD25, and CD103. Protein electrophoresis showed Hypergammaglobulinemia (IgM).
How Yumizen Can Assist: The monocytosis with high ALY, triggered the alarm of abnormal WBC Diff, along with the suspicions on lymphocytes – “Lymphocyte Monocyte peak”to look for abnormal morphology on microscopic review, created a well-defined approach and led a right diagnosis. Pseudo-Cytosis of WBC differential should be well investigated even though there are not many changes in basic CBC counts. Here the Yumizen H2500 hematology analyzer and Yumizen P8000 (HELO middleware) inbuild with ISLH reflex rules gave clues for the right approach and diagnosis.
Microscopy showed abnormal small to medium sized lymphoid cells with oval or indented nucleus, ground glass chromatin, inconspicuous nucleoli, and abundant cytoplasm with circumferential hairy projections.
This clinical case has been provided by Pathology Laboratory Mumbai, India.
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