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Blood, 4 June 2009, Vol. 113, No. 23, pp. 5701. This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Search for Related Content Related Collections Blood Work Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  BLOOD WORK Pancytopenia and large spleen View larger version (37K): [in this window] [in a new window]   Neil Abramson, Baptist Cancer Institute, University of Florida-Jacksonville   A 67-year-old man developed left-sided abdominal pain while struggling to get out of a sand trap on the golf course. He visited his physician and a very large spleen was found on examination. He had been well previously and was on no medications. His brother recently died with metastatic colon cancer; otherwise the family history was negative. Laboratory assessment revealed mild anemia with occasional oval and tear-shaped red cells. There was mild thrombocytopenia with a moderate degree of granulocytopenia. Rare lymphocytes on the peripheral smear appeared as shown in the figure. A bone marrow examination is also illustrated. Special studies were done that added further confirmation to the diagnosis of hairy cell leukemia; the cells were TRAP-positive and B-cell phenotype with CD11c expression. He was given options for treatment including observation only. Since his pain disappeared and he was again asymptomatic, he declined treatment. However, within the next 2 years, he had 2 pulmonary infections, convincing him to agree to treatment. He preferred pentostatin given every 2 weeks rather than a weeklong continuous infusion of cladribine. After 2 months, his spleen was not palpable and the pancytopenia resolved. Minimal numbers of hairy cells were still noted on the bone marrow examination. He remains well, 5 years after chemotherapy. Despite the availability of highly effective chemotherapy, hairy cell leukemia may still be managed without immediate aggressive treatment in some patients.   The above image was first published in the ASH IMAGE BANK, a reference and teaching tool that is continually updated with new atlas images and images of case studies. For more information or to contribute to the Image Bank, visit ashimagebank.hematologylibrary.org. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Search for Related Content Related Collections Blood Work Social Bookmarking                   What's this?

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