Paraproteinaemia plus osteolytic lesions in typical hairy-cell leukaemia

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Abstract
Most cases of hairy-cell leukemia (HCL) involve proliferations of neoplastic B lymphocytes. In rare cases, M-proteins or osteolytic lesions were documented in patients with HCL. Two patients with typical HCL are reported in whom both paraproteinemia and osteolytic lesions of the femoral neck developed. In 1 of the patients the production of the M-protein by hairy cells could be established. In the other patient, at autopsy, no signs of myeloma were found. The hairy cells from inside the osteolytic lesion had the same immunological phenotype as hairy cells from the peripheral blood, the spleen and other parts of the bone marrow. These cases once more confirm the B cell nature of many cases of HCL, and show that hairy cells can have functional capacities usually attributed to much more mature B lymphocytes, i.e., plasma cells.