Differential diagnosis of large granular lymphocyte (LGL) leukemia.
| . | LGL Leukemia . | Hairy Cell Leukemia . | CLL/SLL . | Follicular NHL . | Reactive Lymphocytosis . |
|---|---|---|---|---|---|
| Abbreviations: CLL/SLL, chronic lymphocytic leukemia/small lymphocytic lymphoma; NHL, non-Hodgkins lymphoma | |||||
| Cytology (peripheral blood) | LGL | Hairy cells | Small lymphocytes | Cleaved lymphocytes | Atypical lymphocytes and LGL |
| Liver | Sinus and portal infiltrates | Sinus and portal infiltrates | Sinus and portal infiltrates | Portal infiltrates infiltrates Hepatocyte injury | Sinus and portal |
| Spleen | Red pulp infiltrate Plasmacytosis Follicular hyper- plasia of white pulp | Red pulp infiltrate Red cell “lakes” Reduction of white pulp | Primary expan- sion of white pulp Frequent infiltration of red pulp | White pulp infiltrate | Red pulp infiltrate (immunoblasts, neutrophils) |
| Bone marrow | Diffuse or nodular pattern Usually nonparatra- becular Often subtle involvement Maturation arrest | Diffuse pattern Frequent “dry tap” becular | Diffuse or nodular pattern Usually nonparatra- | Usually nodular pattern | Usually diffuse pattern Plasmacytosis ParatrabecularSometimes granulomas |
| . | LGL Leukemia . | Hairy Cell Leukemia . | CLL/SLL . | Follicular NHL . | Reactive Lymphocytosis . |
|---|---|---|---|---|---|
| Abbreviations: CLL/SLL, chronic lymphocytic leukemia/small lymphocytic lymphoma; NHL, non-Hodgkins lymphoma | |||||
| Cytology (peripheral blood) | LGL | Hairy cells | Small lymphocytes | Cleaved lymphocytes | Atypical lymphocytes and LGL |
| Liver | Sinus and portal infiltrates | Sinus and portal infiltrates | Sinus and portal infiltrates | Portal infiltrates infiltrates Hepatocyte injury | Sinus and portal |
| Spleen | Red pulp infiltrate Plasmacytosis Follicular hyper- plasia of white pulp | Red pulp infiltrate Red cell “lakes” Reduction of white pulp | Primary expan- sion of white pulp Frequent infiltration of red pulp | White pulp infiltrate | Red pulp infiltrate (immunoblasts, neutrophils) |
| Bone marrow | Diffuse or nodular pattern Usually nonparatra- becular Often subtle involvement Maturation arrest | Diffuse pattern Frequent “dry tap” becular | Diffuse or nodular pattern Usually nonparatra- | Usually nodular pattern | Usually diffuse pattern Plasmacytosis ParatrabecularSometimes granulomas |