case_images: PMC9938344_01
case_images: Peripheral blood smear showing characteristic hairy cell along with marked thrombocytopenia and hypochromic anemia with nucleated RBCs and anisocytosis. RBCs: Red blood cells.
case_images: cureus-0015-00000033949-i01.jpg
case_images: PMC9938344_01_cureus-0015-00000033949-i01.jpg
case_images: FIG1
case_images: The peripheral blood smear showed marked thrombocytopenia without aggregation and hypochromic anemia with the presence of nucleated red blood cells and anisocytosis (Figure 1).
case_images: A hypercellular bone marrow packed with small leukemic cells having moderate light basophilic cytoplasms and circumferential hairy projections. This image was originally published in the American Society of Hematology (ASH) Image Bank.
case_images: cureus-0015-00000033949-i02.jpg
case_images: PMC9938344_01_cureus-0015-00000033949-i02.jpg
case_images: FIG2
case_images: The reticulin stain demonstrated no significant increase in reticulin fibers (Figure 2).
case_images: Flow cytometry showing clonal CD19 and CD20-positive B-cell population with kappa restriction and CD11c, CD25 and CD103. This image was originally published in the American Society of Hematology (ASH) Image Bank.. CD: Cluster of differentiation.
case_images: cureus-0015-00000033949-i03.jpg
case_images: PMC9938344_01_cureus-0015-00000033949-i03.jpg
case_images: FIG3
case_images: The patient's flow cytometry analysis revealed clonal cluster of differentiation 20 (CD20)-positive B cells with CD11c, CD25, CD103, CD10, and kappa (kappa) light chain restrictions, which are highly suggestive of HCL (Figure 3).
case_images: Bone marrow showing CD20-positive leukemic cells. CD: Cluster of differentiation.
case_images: cureus-0015-00000033949-i04.jpg
case_images: PMC9938344_01_cureus-0015-00000033949-i04.jpg
case_images: FIG4
case_images: The leukemic cells were positive for CD20, CD25, CD10, Annexin A1, and tartrate-resistant acid phosphatase (TRAP) stain and negative for CD123 (Figures 4-7).
case_images: Bone marrow showing CD25-positive leukemic cells. CD: Cluster of differentiation.
case_images: cureus-0015-00000033949-i05.jpg
case_images: PMC9938344_01_cureus-0015-00000033949-i05.jpg
case_images: FIG5
case_images: The leukemic cells were positive for CD20, CD25, CD10, Annexin A1, and tartrate-resistant acid phosphatase (TRAP) stain and negative for CD123 (Figures 4-7).
case_images: Bone marrow showing leukemic cells positively staining with Annexin A1
case_images: cureus-0015-00000033949-i06.jpg
case_images: PMC9938344_01_cureus-0015-00000033949-i06.jpg
case_images: FIG6
case_images: The leukemic cells were positive for CD20, CD25, CD10, Annexin A1, and tartrate-resistant acid phosphatase (TRAP) stain and negative for CD123 (Figures 4-7).
case_images: Bone marrow showing leukemic cells positively staining with TRAP stain. TRAP: Tartrate-resistant acid phosphatase.
case_images: cureus-0015-00000033949-i07.jpg
case_images: PMC9938344_01_cureus-0015-00000033949-i07.jpg
case_images: FIG7
case_images: The leukemic cells were positive for CD20, CD25, CD10, Annexin A1, and tartrate-resistant acid phosphatase (TRAP) stain and negative for CD123 (Figures 4-7).