A Rare Case of Dual Clonal B-Cell Hairy Cell Leukemia: Diagnostic Challenges.

IF 0.7 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY

Clinical laboratory Pub Date : 2025-05-01 DOI:10.7754/Clin.Lab.2024.241119

Zhaoxia Luo, Jinfeng Lai

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引用次数: 0

Abstract

Background: Hairy Cell Leukemia (HCL) is a rare chronic B-cell disorder characterized by cytopenia, splenomegaly, and bone marrow infiltration. A 42-year-old female presented with gingival swelling and bleeding, later diagnosed with HCL involving lymph nodes, liver, and spleen.

Methods: The patient underwent blood tests, PET-CT, bone marrow flow cytometry, biopsy, and lymph node as-piration, confirming HCL. Notably, flow cytometry revealed dual clonal B-cell populations, both CD5-negative and CD10-negative. Immunohistochemistry showed positive B-cell markers (CD20, CD23) and BRAF-V600E mu-tation. Cladribine chemotherapy began on April 18, 2022, followed by supportive treatment.

Results: Blood tests showed pancytopenia, and PET-CT indicated lymph node, spleen, liver, and bone marrow involvement. Bone marrow biopsy confirmed HCL with fibrosis. The patient experienced bone marrow suppression during chemotherapy and received supportive care, eventually leading to a successful discharge.

Conclusions: HCL is a rare B-cell malignancy causing pancytopenia and organ involvement. The identification of dual clonal B-cell populations is crucial for accurate diagnosis. Early diagnosis and cladribine chemotherapy are effective. Immunohistochemical and genetic testing are key for diagnosis and treatment planning.

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一例罕见的双克隆b细胞毛细胞白血病：诊断挑战。

背景：毛细胞白血病（HCL）是一种罕见的慢性b细胞疾病，以细胞减少、脾肿大和骨髓浸润为特征。42岁女性，以牙龈肿胀和出血表现，后诊断为HCL累及淋巴结、肝脏和脾脏。方法：患者接受血液检查、PET-CT、骨髓流式细胞术、活检和淋巴结穿刺，证实HCL。值得注意的是，流式细胞术显示双克隆b细胞群，cd5阴性和cd10阴性。免疫组化显示阳性b细胞标志物（CD20、CD23）和BRAF-V600E突变。克拉德滨化疗于2022年4月18日开始，随后进行支持性治疗。结果：血液检查显示全血细胞减少，PET-CT显示淋巴结、脾脏、肝脏和骨髓受累。骨髓活检证实HCL伴纤维化。患者在化疗期间经历骨髓抑制并接受支持性治疗，最终成功出院。结论：HCL是一种罕见的b细胞恶性肿瘤，引起全血细胞减少和器官受累。双克隆b细胞群的鉴定是准确诊断的关键。早期诊断和克拉宾化疗是有效的。免疫组织化学和基因检测是诊断和治疗计划的关键。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical laboratory 医学-医学实验技术

CiteScore

1.50

自引率

0.00%

发文量

494

审稿时长

3 months

期刊介绍： Clinical Laboratory is an international fully peer-reviewed journal covering all aspects of laboratory medicine and transfusion medicine. In addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies. The journal publishes original articles, review articles, posters, short reports, case studies and letters to the editor dealing with 1) the scientific background, implementation and diagnostic significance of laboratory methods employed in hospitals, blood banks and physicians'' offices and with 2) scientific, administrative and clinical aspects of transfusion medicine and 3) in addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies.