Skeletal involvement in hairy cell leukemia

The clinical and radiographic aspects of two patients with destructive bone lesions, complicating the course of hairy cell leukemia are presented. The findings are compared with those of 27 previously published cases. The most prominent features of this rare skeletal disorder are osteolysis and widespread or localized demineralisation with predilection for the femoral head and neck. Localized persisting pain is the leading clinical symptom in all cases. Magnetic resonance imaging is helpful in evaluating the extent of bone marrow infiltration and demonstrates focal areas of decreased signal intensity in sites of radiographically detectable bone destruction as well as in bones that appear normal on plain films.