Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc
Journal website https://jh.elmerpub.com

Case Report

Volume 000, Number 000, April 2025, pages 000-000

Hairy Cell Leukemia With Splenic Rupture: Hematological Changes and Disappearance of Hairy Morphology After Splenectomy

Figures

Figure 1.
Figure 1. Morphology changes of hairy cells before and after splenectomy (× 100). (a) Before splenectomy; (b) post-splenectomy day 7; (c) post-splenectomy day 13; (d) post-splenectomy day 26; (e) post-splenectomy day 54; (f) post-splenectomy day 84.
Figure 2.
Figure 2. CT scan showing an enlarged spleen with capsular hematomas (arrows). CT: computed tomography.
Figure 3.
Figure 3. Removed spleen showing enlarged, ruptured, and necrotic spleen with the embolization coil (arrow).
Figure 4.
Figure 4. Positive immunohistochemical stain for mutant BRAF V600E protein in the cytoplasm of HCL cells of the spleen. (a): × 10; (b): × 20. HCL: hairy cell leukemia.
Figure 5.
Figure 5. H&E stained bone marrow shows the infiltrates by HCL. (a): × 10; (b): × 20; (c): magnifying view of the bone marrow showing fried egg appearance of HCL cells (arrows). HCL: hairy cell leukemia; H&E: hematoxylin and eosin.
Figure 6.
Figure 6. The trends of WBCs, Hb, platelet count, and circulating hairy cells are compared in an integrated graph. Hb: hemoglobin; WBCs: white blood cells.

Table

Table 1. Changes in Blood Cells and Hairy Cells After Splenectomy
 
Splenectomy dayWBCANCALCAMCHbPlateletHairy cells %
aAdmission day; bDay of splenectomy. ANC: absolute neutrophil count; ALC: absolute lymphocyte count; AMC: absolute monocyte count; Hb: hemoglobin; WBC: white blood cell.
Day 13a10.897320
Day 0b2.80.81.308.88820
Day 13.521.40.112.37220
Day 26.11.54.40.210.79120
Day 33.80.63010.3Clump20
Day 74.31.82.507.35820
Day 131.60.50.90.18.488< 5
Day 261.80.31.409.8120< 5
Day 402.10.81.309.2172< 5
Day 541.60.60.80.28.8173< 5
Day 682.61.21.208.6230< 1
Day 842.81.51.10.29.1225< 1
Day 982.50.81.409.4211< 1
Day 1123.21.21.80.210.1208< 1