Hairy cell leukemia

Case history

A middle-aged man presents with complaints of acute onset of abdominal discomfort and a feeling of 'fullness', as well as weight loss. The patient also complains of shortness of breath and fatigue. Physical examination reveals pallor and splenomegaly.

Other presentations

Other presentations of HCL may include:

• Recurrent infections (due to neutropenia and monocytopenia)

• Bleeding (e.g., gingival bleeding, epistaxis, petechiae) and bruising (due to thrombocytopenia)

• Lymphadenopathy (uncommon)

Rarely, patients present with signs and symptoms of neurologic involvement (e.g., Guillain-Barre syndrome, signs of meningitis, and nerve compression).

Patients may be asymptomatic at presentation, and are diagnosed incidentally during evaluation for an unrelated cause.