title: A patient with a variant form of hairy cell leukaemia.
abstract: A 57-year-old woman was admitted because of weakness, fatigue, abdominal discomfort, easy bruising and splenomegaly. A highly elevated leukocyte count with hairy-cell-like cells was found, the cells being positive for the monoclonal antibodies CD19, FMC7, CD11c and B-ly-7 and negative for CD24 and CD25. Blood and bone marrow were investigated not only in our own laboratory but also in several other laboratories resulting in a variety of possible diagnoses. Only after combining all data could a definitive diagnosis of variant hairy cell leukaemia be made. The patient was treated initially with a splenectomy and later on with interferon-alpha-2b, resulting in a steady decrease in the leukocyte count. After a follow-up of 2 years a nearly complete remission was obtained with a good quality of life. The differential diagnosis of this rare disorder is discussed with emphasis on the relative contribution of different diagnostic procedures.
authors.affiliation: Sophia Ziekenhuis, Zwolle, Netherlands.
authors.forename: P A
authors.initials: PA
authors.lastname: Kramer
authors.forename: W P
authors.initials: WP
authors.lastname: Oosterhuis
authors.forename: E
authors.initials: E
authors.lastname: van Kammen
authors.forename: B P
authors.initials: BP
authors.lastname: Hazenberg
authors.forename: J C
authors.initials: JC
authors.lastname: Balhuizen
authors.forename: R B
authors.initials: RB
authors.lastname: Dinkelaar
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007159:Immunologic Tests; D007943:Leukemia, Hairy Cell / Q000175:diagnosis* / Q000276:immunology; D008875:Middle Aged