Extranodal hairy cell leukemia presenting in the lumbar spine

Rosen, David S.; Smith, Sonali M.; Gurbuxani, Sandeep; Yamini, Bakhtiar

doi:10.3171/spi.2008.9.10.374

Cited by 16 publications

(16 citation statements)

References 7 publications

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“…Snell et al reported a patient who presented with a pathological femoral fracture 22 years after HCL diagnosis, which is the longest documented period between HCL diagnosis and subsequent bony involvement [ 30 ]. Rosen et al reported a 54-year-old man who presented with a L5 vertebral body lesion and a lumbar epidural lesion extending from L3 to S2 [ 31 ]. Biopsy sampling of the epidural mass demonstrated CD20-positive B cells that expressed TRAP and CD25, consistent with a diagnosis of HCL.…”

Section: Discussionmentioning

confidence: 99%

Hairy Cell Leukemia Presenting with Isolated Skeletal Involvement Successfully Treated by Radiation Therapy and Cladribine: A Case Report and Review of the Literature

Yonal-Hindilerden

Hindilerden

Bulut-Dereli

et al. 2015

Case Reports in Hematology

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We describe an unusual case of hairy cell leukemia (HCL) in a 55-year-old male presenting with isolated skeletal disease as the initial manifestation without abnormal peripheral blood counts, bone marrow involvement, or splenomegaly. To the best of our knowledge, there have been only two previous reports of a similar case. The patient presented with pain in the right femur. Anteroposterior radiographs of both femurs revealed mixed lytic-sclerotic lesions. PET scan showed multiple metastatic lesions on axial skeleton, pelvis, and both femurs. Histopathological examination of the bone biopsy revealed an infiltrate of HCL. Localized radiation therapy to both proximal femurs and subsequently 4 weeks later, a 7-day course of 0.1 mg/kg/day cladribine provided complete remission with relief of symptoms and resolution of bone lesions. We addressed the manifestations and management of HCL patients with skeletal involvement.

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Section: Discussionmentioning

confidence: 99%

Hairy Cell Leukemia Presenting with Isolated Skeletal Involvement Successfully Treated by Radiation Therapy and Cladribine: A Case Report and Review of the Literature

Yonal-Hindilerden

Hindilerden

Bulut-Dereli

et al. 2015

Case Reports in Hematology

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“…Rosen et al described a case of a 54-year-old male who presented with severe back pain and numbness and weakness in his lower extremities [19]. The patient underwent a surgery for epidural lesion, which was later found to be HCL.…”

Section: Discussionmentioning

confidence: 99%

Pancytopenia in a 70-Year-Old African-American Male: An Unusual Presentation of a Rare Disease

Mirrakhimov

Ali

Barbaryan

et al. 2014

Case Reports in Hematology

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Hairy cell leukemia is a rare lymphoid neoplasm arising from mature B-lymphocytes. Clinically, the disease presents with splenomegaly and abdominal discomfort, frequent infections, fatigue and bleeding because of related cytopenias. Bone marrow biopsy is essential for diagnosis. Below we describe a case of a 70-year-old African-American male who presented to our hematology clinic complaining of fatigue. Clinical exam and computed tomography imaging did not reveal splenic enlargement. Blood work-up revealed pancytopenia and bone marrow was diagnostic for hairy cell leukemia.The patient was started on cladribine, with gradual improvement of his symptoms and blood count abnormalities. Therefore, it is essential to keep hairy cell leukemia in the differential of pancytopenia even in the absence of a splenomegaly.

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“…Saçlı hücreli löseminin bu şekide izole kemik tutulumu çok nadirdir. Literatürde bu durumda sadece birkaç olgu bildirilmiştir (4,(7)(8)(9). Bu açıdan bakıldığında sunduğu-muz olgu literatüre katkı sunmaktadır.…”

Section: Resim 3 Hastadan Alınan Diz Biyopsisindeki Litik Lezyonun Munclassified

Hairy Cell Leukemia Presenting with Isolated Bone Lesions

Gündüz¹,

Ozen²,

Yüksel³

et al. 2017

LLM Dergi

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ÖZETÇok az sayıda izole kemik tutulumu ile ortaya çıkan saçlı hücreli lösemi olgusu bildirilmiştir. Biz burada izole kemik lezyonları olan bir saçlı hücreli lösemi olgusunu bildiriyoruz. Hastanemize 48 yaşında bir erkek 3 yıldır olan sol diz ağrısı ile başvurdu. Hastanın önceki şikayetleri sırasında manyetik rezonans görüntüleme yapılmış olup herhangi bir patolojik bulguya rastlanmamıştı. Direkt röntgen incelemede tibiada kistik infiltratif bir lezyon gözlendi. Hastanın bilgisayarlı tomografi görüntülemesi ılımlı splenomegali dışında normaldi. Tüm vücut pozitron emisyon tomografisinde kemiklerde çok sayıda patolojik tutulum mevcuttu. Kemik iliği biyopsisi ve aspirasyonun morfolojisi ile akım sitometrisi herhangi bir tutulum olmaksızın normaldi. Bunun üzerine tibiadaki lezyondan kemik biyopsisi yapıldı. Yapılan kemik biyopsisinin morfolojisi tipik saçlı hücreli lösemi ile uyumluydu. İmmünhistokimya sonuçlarında güçlü CD20, CD25, anneksin A1; soluk siklin D1 pozitifliği ve %5'ten daha az Ki 67 proliferasyon indeksi saptandı. Sanger sekans yöntemiyle yapılan moleküler analizde saçlı hücreli lösemi tanısını destekleyen BRAF V600E mutasyonu gözlendi. Hasta 7 gün 0.1 mg/kg kladribin ve ek lokal radyoterapi aldı. Hasta 3 yıl sonra hala remisyonda olup ilerleyici lezyonları bulunmamaktadır. Sonuç olarak, saçlı hücreli lösemi hastalarında nadir bir ortaya çıkış şekli olan izole kemik tutulumuna tanısal araç olarak BRAF V600E mutasyonuna dikkat çekmek istiyoruz.Anahtar Sözcükler: Saçlı hücreli lösemi; İzole kemik lezyonları; BRAF V600E mutasyonu ABSTRACT A few cases with hairy cell leukemia presented by isolated bone involvement were reported. Herein we report a case with hairy cell leukemia with isolated bone lesions. A 48-year-old male admitted to our hospital with a left knee pain for three years. Magnetic resonance imaging was performed during his previous complaints and did not reveal any pathological findings. Conventional X-Ray revealed a cystic infiltrative left tibia lesion. The computed tomography scan was normal except slight splenomegaly. The total body positron emission tomography scan revealed multiple pathologic involvements in bones. Bone marrow biopsy and aspiration morphology with flow cytometry were normal without any involvement. Thus, bone biopsy was performed from the tibia lesion. The morphology of the bone biopsy with the immunohistochemistry revealed typical features of hairy cell leukemia with strong CD20, CD25, annexin A1, faint cyclin D1 positivity and less than 5% proliferation indexes with Ki67. Molecular analysis with sanger sequencing revealed BRAF V600E mutation supporting hairy cell leukemia diagnosis. The patient was treated with cladribine, 7 days, 0.1 mg/kg and additional local radiotherapy. After 3 years, the patient is still on remission and had no progressive lesions. As a conclusion, we would like to take an attention for isolated bone involvement as a rare presentation and BRAF V600E mutation as a diagnostic tool in hairy cell leukemia patients.

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Extranodal hairy cell leukemia presenting in the lumbar spine

Cited by 16 publications

References 7 publications

Hairy Cell Leukemia Presenting with Isolated Skeletal Involvement Successfully Treated by Radiation Therapy and Cladribine: A Case Report and Review of the Literature

Hairy Cell Leukemia Presenting with Isolated Skeletal Involvement Successfully Treated by Radiation Therapy and Cladribine: A Case Report and Review of the Literature

Pancytopenia in a 70-Year-Old African-American Male: An Unusual Presentation of a Rare Disease

Hairy Cell Leukemia Presenting with Isolated Bone Lesions

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