Which physical findings are characteristic of hairy cell leukemia (HCL)?

Updated: Sep 16, 2018
  • Author: Emmanuel C Besa, MD; Chief Editor: Koyamangalath Krishnan, MD, FRCP, FACP  more...
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Splenomegaly is the most common physical finding in hairy cell leukemia. It is present in virtually every patient with the disease and it is massive in more than 80% of patients. Hepatomegaly with mild liver function abnormalities is found in 20% of cases, and lymphadenopathy is found in 10%.

A low-grade fever is part of the disease, but it may alsobe due to an infection from the resulting neutropenia. In more than half of the cases, it is from a gram-negative organism. Atypical mycobacterial infections are common. Disseminated fungal infections and Pneumocystis jiroveci pneumonia may occur in some cases of hairy cell leukemia.

Peripheral lymphadenopathy is uncommon; fewer than 10% of patients present with peripheral nodes larger than 2 cm in diameter. However, internal adenopathy may develop after a prolonged disease course and was found in 75% of patients at autopsy.

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