Journal of Isfahan Medical School

Journal of Isfahan Medical School

Composite lymphoma including Classic Hairy Cell Leukemia and Chronic Lymphocytic Leukemia: A Case Report

Document Type : Case Report

Authors
Pardis Nematollahi 1
Zahra Kasaei Koopaei 1
Mehran Sharifi 2
1 Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.48305/jims.v44.i877.2314
Abstract
Background: Concurrent classic hairy cell leukemia (HCL) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) in one anatomic site is rare and may be overlooked, particularly when one clone predominates.
Methods: Clinical findings include , complete blood count (CBC),, bone marrow aspirate and biopsy, immunohistochemistry, and multiparameter flow cytometry were reviewed in a 68-year-old man presenting with lymphocytosis and splenomegaly.
Findings: Clinical findings reported as below: the white blood cell count was 23,000/µL and platelet count was 102,000/µL. Marrow examination identified two distinct abnormal B-cell populations. Approximately 30% showed a κ-restricted CD19+/CD5+/CD23+/CD200+ CLL phenotype with dim CD20 and surface immunoglobulin. Approximately 10% comprised cells with abundant pale cytoplasm and irregular projections, expressing bright CD20, annexin A1, CD11c, CD25, and CD103, consistent with classic HCL.
Conclusion: Concordant morphologic and immunophenotypic findings supported synchronous marrow involvement by classic HCL and CLL/SLL. Recognizing and separately quantifying both components is important for accurate diagnosis and treatment planning.

Highlights

Pardis Nematolahy: Google Scholar

Zahra Kasaei Koohpaei : Google Scholar

Keywords
Bone Marrow
Flow Cytometry
Composite lymphoma
Splenomegaly
Lymphocytosis
Subjects
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Journal of Isfahan Medical School
Volume 44, Issue 877
4th Week, October
September and October 2026
Pages 2314-2318

  • Receive Date 13 October 2026
  • Accept Date 27 October 2026