case_images: PMC10911873_01
case_images: Bone marrow biopsy. (a) CD25 IHC, 4x. (b) CD103 IHC, 4x. (c) CD11c IHC, 4x. (d) CD22 IHC, 4x. (e) CD20 IHC, 4x.
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case_images: fig1
case_images: The gross cell immunophenotypes were identified as CD25+, CD103+, CD11c+, CD20+, CD19+, and CD22+ (Figure 1).
case_images: HCL cells in bone marrow smear (wright stain, 40x). HCL cytological features: fried egg-like changes; brush-like protrusions at the edge of the hairy cell envelope.
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case_images: fig2
case_images: In addition, the bone marrow biopsy revealed evidence of active hyperplasia, with certain tumor cells displaying a distinct "fried-egg" morphology characterized by well-defined cell membranes and copious clear cytoplasm (Figure 2).
case_images: Bone marrow biopsy. (a) H&E, 2x. (b) H&E, 40x.
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case_images: fig3
case_images: The bone marrow trephine biopsy additionally substantiated the extensive infiltration of the marrow (Figure 3), concomitant with the presence of the BRAFV600E gene mutation.
case_images: (a) The patient with a large skin ulcer on the right lower extremity with obvious yellowish exudate, high skin temperature, and red skin color with pain. (b) Patients are given Coptis fluid to apply wet on the top of the wound for 30 minutes.
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case_images: fig4
case_images: On November 28, 2022, the patient sought medical attention at our hospital, presenting with a sizable skin ulcer on the right lower extremity that displayed evident yellowish exudate, elevated skin temperature, red coloration, and pain (Figure 4(a)). In addition, topical treatment was provided by applying Coptis liquid through a wet compress on the wound for a duration of 30 minutes (Figure 4(b)).
case_images: (a-f): Pictures of the patient after treatment: (a, b) 8 days of treatment; (c, d) 13 days of treatment; (e, f) 3 months follow-up.
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case_images: fig5
case_images: However, there was a reduction in exudate production, and the affected skin exhibited a crust formation that was more limited in extent compared to previous observations (Figures 5(a) and 5(b)). Following a 13-day treatment period (Figures 5(c) and 5(d)), the patient's initial extensive ulcerated skin surface crust and exudates had substantially diminished, accompanied by a reduction in skin temperature. After a subsequent 3-month follow-up, the skin crusts had completely resolved (Figures 5(e) and 5(f)).