SHM Converge Scientific Abstract ePoster Gallery-My Belly Hurts: A Rare Case of Hairy Cell Leukemia

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This case report describes a 45-year-old woman who presented with 3 days of sharp abdominal pain, vomiting, fever, and chills. She was found to have severe pancytopenia, including leukopenia, anemia, and thrombocytopenia. CT imaging showed inflammation and possible ischemia/perforation involving the terminal ileum, cecum, and ascending colon, leading to an open right hemicolectomy.<br /><br />Despite treatment with antibiotics, filgrastim, and multiple transfusions, her blood counts remained very low. Further hematologic workup with flow cytometry and bone marrow biopsy revealed a monoclonal B-cell disorder. Findings such as CD20 positivity and a BRAF V600E mutation confirmed the diagnosis of classic hairy cell leukemia (HCL).<br /><br />The report reviews HCL as a rare, slow-growing B-cell malignancy that affects the bone marrow, blood, and spleen. It typically presents with nonspecific symptoms such as fatigue, weakness, abdominal discomfort, splenomegaly, and cytopenias. Diagnosis relies on peripheral blood smear, flow cytometry, and bone marrow biopsy. HCL cells characteristically express markers such as CD19, CD20, CD22, CD25, CD11c, and CD103. The BRAF V600E mutation plays a key role in disease development.<br /><br />Treatment depends on patient condition and infection status. Cladribine is a standard therapy, and rituximab may be added. Although HCL is considered incurable, treatment can lead to long survival, often close to that of the general population.<br /><br />The authors emphasize that HCL should be considered in younger patients with unexplained abdominal symptoms and pancytopenia, especially when imaging and surgical findings do not fully explain the degree of hematologic abnormality.

Asset Subtitle

Dina Yusupova

Meta Tag

Author List Alexander Belkin, Alexander Rodrigues, Amishi Desai, Dina Yusupova, Gayatri Bobba, Riliwan Adekiigbe

Category Clinical Vignettes

Concept Hairy Cell Leukemia

Concept BRAF V600E Mutation

Concept Pancytopenia

Concept Splenomegaly

Concept RAF-MEK-ERK Signaling Pathway

Distinguished Non-Finalist

Presenter Organization Long Island Community Hospital

Presenting Author Dina Yusupova

Track Adult

Keywords

hairy cell leukemia

pancytopenia

abdominal pain

BRAF V600E mutation

flow cytometry

bone marrow biopsy

monoclonal B-cell disorder

right hemicolectomy

classic HCL

cytopenias

Hairy Cell Leukemia

BRAF V600E Mutation

Pancytopenia

Splenomegaly

RAF-MEK-ERK Signaling Pathway