Anemia hemolítica autoinmune severa como manifestación de linfoma no Hodgkin B de bajo grado: Dilema diagnóstico y terapéutico

Hairy cell leukemia (LCV) and splenic marginal zone lymphoma (LME) are two lymphoproliferative disorders that usually have in common a similar clinical presentation with splenomegaly, cytopenias and an indolent clinical course. It is essential to make a proper differential diagnosis, since the therapeutic approach and prognosis differ between both entities. LCV responds to treatment with nucleoside analogs, while LME treatment options include splenectomy or rituximab. The diagnostic approach includes imaging studies, flow cytometry and pathology of bone marrow, although the results of these methods are not always conclusive. We report a clinical case that had an acute and severe presentation, with autoimmune hemolytic anemia and it also implied a diagnostic challenge in which the use of a novel method was helpful to arrive to a definitive diagnosis and an accurate treatment.