title: Sporotrichosis as a presenting manifestation of hairy cell leukemia.
abstract: An infectious episode is the presenting manifestation of hairy cell leukemia (HCL) in approximately 30% of cases. Most often this is bacterial and only rare cases of opportunistic fungal infection are described. We report a patient who presented with sporotrichal involvement of multiple cutaneous sites and lymph nodes. The lesions resolved following antifungal therapy, but persisting pancytopenia and splenomegaly necessitated further hematological evaluation. A diagnosis of HCL was suspected based on morphologically characteristic hairy cells in the peripheral blood that contained tartrate resistant acid phosphatase. A bone marrow biopsy specimen had a normocellular marrow with an increase in interstitial lymphoid cells that stained with L26, MB2, and LN2 antibodies. On flow cytometry these cells were positive for the leukocyte common antigen, B cell markers, and the CD11c antigen confirming the diagnosis of HCL. We believe that this is the first report of sporotrichosis infection as a presenting manifestation of HCL.
authors.affiliation: Department of Pathology, University of Texas Medical Branch, Galveston 77555.
authors.forename: S
authors.initials: S
authors.lastname: Kumar
authors.forename: D
authors.initials: D
authors.lastname: Kumar
authors.forename: W K
authors.initials: WK
authors.lastname: Gourley
authors.forename: J B
authors.initials: JB
authors.lastname: Alperin
mesh_terms: D006801:Humans; D016130:Immunophenotyping; D007943:Leukemia, Hairy Cell / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013174:Sporotrichosis / Q000150:complications* / Q000175:diagnosis