Hairy cell leukemia differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Overview

• Hairy cell leukemia must be differentiated from other diseases that cause weight loss, fatigue, splenomegaly, and fever, such as chronic lymphocytic leukaemia, prolymphocytic leukaemia, follicular lymphoma, and mantle cell lymphoma.

Differenting Hairy cell leukemia from other Diseases

• Hairy cell leukemia must be differentiated from other diseases that cause weight loss, fatigue, splenomegaly, and fever, such as chronic lymphocytic leukaemia, prolymphocytic leukaemia, follicular lymphoma, and mantle cell lymphoma.

Differential Diagnosis	Surface Immunoglobulin	CD5	CD22/FMC7	CD23	CD79b	CD103
Hairy cell leukaemia	Strongly positive	Negative	Positive	Negative	Positive/Negative	Positive
Chronic lymphocytic leukaemia	Weakly positive	Positive	Negative	Positive	Negative	Positive/Negative
Prolymphocytic leukaemia	Strongly positive	Negative	Positive	Negative	Positive	Negative
Mantle cell lymphoma	Positive	Positive	Strongly positive	Negative	Strongly positive	Negative
Follicular lymphoma	Strongly positive	Negative	Positive	Negative	Strongly positive	Negative

• Hairy cell leukemia must also be differentiated from other causes of fever, splenomegaly, and fatigue such as:

• Aplastic anemia
• Myelodysplastic syndrome
• Splenic marginal zone lymphoma
• B-cell prolymphocytic leukemia
• Idiopathic myelofibrosis

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