Hairy cell leukemia: report of an unusual case with hepatomegaly due to a large vascular tumor of the liver, mediastinal mass and pleural effusion containing hairy cells

Hairy cell leukemia presenting as a discrete liver mass: diagnosis by fine needle aspiration biopsy

Hairy cell leukemia, a chronic low-grade lymphoproliferative disorder first recognized in mid 1920's typically involves the lymphoreticular system, especially the spleen and the bone marrow. Clinically, it tends to present with pancytopenia and splenomegaly. Liver involvement, if present, is usually in a sinusoidal and a periportal pattern. We report a case of hairy cell leukemia associated with a liver mass 20 years after the initial presentation. To our knowledge, this is the first case of hairy cell leukemia presenting as a solid liver mass diagnosed by a percutaneous ultrasound guided fine needle aspiration biopsy to be reported in the English literature.

Lymphomas of the mediastinum

The purpose of this clinicopathologic overview is to describe the types of lymphomas that present in the mediastinum. A comparison of the frequency of the different subtypes of lymphoma that are found in children and adults is provided. In general, immunohistochemistry and immunophenotyping studies are essential to the laboratory workup of neoplasms presenting in the mediastinum. An assessment of proliferative index in lymphoma is most helpful to determine tumor aggressiveness and patient prognosis. Electron microscopy is most helpful in the differential diagnosis of mediastinal neoplasms, where lymphomas may be distinguished from nonlymphomatous neoplasms using key ultrastructural features. The role of electron microscopy in the subclassification of lymphomas is mostly academic, with a few exceptions. The varied ultrastructural appearance of Hodgkin's cells and of different subtypes of non-Hodgkin's lymphoma is illustrated, using cases from our patient files. An ultrastructural study of lacunar cells in Hodgkin's disease provides evidence that the formation of lacunae may have a structural and/or physiologic basis. Mummified cells showing some of the features of a physiologic form of cell death, called apoptosis, are also described.

Hairy cell leukemia--mediastinal involvement. A report of two cases and review of the literature

The clinical features of two patients with hairy cell leukemia involving the mediastinum are described. Both patients presented with acute chest pain 2-3 months prior to diagnosis being made. In one patient mediastinal disease was recorded only by computerized tomography of the thorax. There was good response of mediastinal disease to alpha-interferon in both patients, in spite of persisting bone marrow involvement with hairy cell leukemia.

The value of the Wright-Giemsa stain for diagnosing hairy cell leukemia in body cavity fluids

We compared the value of the Wright-Giemsa stain with the Papanicolaou stain for diagnosing hairy cell leukemia in the body cavity fluids of three patients. The cytological features of the leukemic cells were much clearer on the Wright-Giemsa-stained preparations. This allowed for the accurate diagnosis of leukemic involvement of the body cavity fluids in 3/3 patients using the Wright-Giemsa stain but only 1/3 using the Papanicolaou stain. A tartrate-resistant acid phosphatase stain was used to confirm the diagnosis in each case.