Disorders To Be Distinguished From Hairy Cell Leukemia

The differential diagnosis of HCL includes other low-grade B-cel! lymphoproKferative disorders, such as hairy cell leukemia-variant (HCL-V), chronic lymphocytic leukemia, splenic lymphoma with circulating villous lymphocytes, marginal zone lymphoma of the spleen, and monocytoid B-cell lymphoma52 (Table 8-2).

Hairy cell leukemia-variant28 represents a hybrid between prolymphocytic leukemia and HCL; the nucleus more closely resembles a prolymphocyte and the cytoplasm a hairy cell. Afflicted individuals present with massive splenomegaly, and in the leukemia phase, TRAP staining is either negative or weakly positive. In contrast to the flow cytometry results in HCL, the cells in HCL-V are usually CD25-negative and CD103 (Bly-7)-negative. Distinction from HCL is based on nuclear morphol

Table 8-2. Differential Diagnosis of Hairy Cell Leukemia Parameters HCL HCL Variant

Splenic Lymphoma with Villous Lymphocytes

Monocytoid B-Cell Lymphoma/ Marginal Zone Lymphoma

Peripheral blood

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