We have a case of an 80 year old male, with bone marrow biopsy showing lymphoproliferative process and enlarged spleen. The bone marrow tumor cells are reported cyclin D1 negative. The case was submitted with a diagnosis of hairy cell. WBC is 2.2 with anemia and thrombocytopenia. The peripheral blood is minimally involved (7% of lymphs). The tumor cells are CD19+, CD20 moderate (not dim), CD22 moderate, Immunoglobulin moderate- kappa/IgA IgM +, CD5 positive but spectrum from dim to moderate, FMC7 + and negative for CD23, CD10, CD103, CD25, CD38, IgD, IgG, and IgE. This doesn't look like CLL or mantle cell. We will be following up on the marrow biopsy and further clinical history and will let you know anything that pops up. Has anyone had a case like this? What is your favorite diagnosis for this? Maryalice Stetler-Stevenson and Doug Kingma Maryalice Stetler-Stevenson Director Flow Cytometry Unit Laboratory of Pathology, NCI, NIH
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