Hairy Cell Leukemia Differential Diagnoses

Updated: Oct 25, 2022
  • Author: Emmanuel C Besa, MD; Chief Editor: Sara J Grethlein, MD, MBA, FACP  more...
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Diagnostic Considerations

Hairy cell leukemia (HCL) must be differentiated from other other peripheral small B-cell lymphoid neoplasms, including hairy cell leukemia variant (HCL‐V), [2] HCL expressing IGHV4-34and splenic diffuse red pulp lymphoma (SDRPL). While those neoplasms are histologically similar to classic HCL, they have a more aggressive clinical course and are less likely to respond to purine analog therapy. [13]

Testing for the BRAF V600E mutation allows for a genetics-based differential diagnosis between HCL and HCL-like tumors, as BRAF V600E is absent in other B-cell neoplasms. [6, 14]

Other problems to be considered in the differential diagnosis of hairy cell leukemia include the following:

Differential Diagnoses