A case of Hairy cell leukemia accompanied with gall bladder cancer is reported.
This 70-year-old female was admitted to our hospital because of general malaise and the evaluation of leukocytosis.
On admission patient was emaciated and was found to have marked hepatosplenomegaly. Lymph nodes were not palpable.
Laboratory data showed WBC count of 62,500/mm3 with 82% mononuclear lymphoid cells which lacked tartrate-resistant acid phosphatase and ribosome-lamella-complex. Under the phase contrast microscope, however, many hairy cytoplasmic projections were present, and the bone marrow biopsy revealed diffuse leukemic cell infiltration and the increment of reticulin fibers indicating that these findings are in accordance with the characteristics of hairy cell leukemia. On chromosomal analysis karyotype abnormality was detected.
Immunological studies showed that the hairy cells had both Ia-like antigens and surface immunoglobulin but lacked Fc receptors, C3 receptors and TdT. These findings may suggest that these cells originated from a B cell lineage. On the analysis of cellular immunity, sensitization with DNCB was unsuccessful, PPD skin test was positive, lymphocyte response to PHA mitogen was normal and the absolute number of lymphocytes and monocytes was normal. Natural killer cell function was almost normal after the removal of hairy cells. The relationship between hairy cell leukemia, impaired immunity and secondary malignancies was discussed.
