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. 2017 Jan 9;6:270. doi: 10.3389/fonc.2016.00270

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Copyright © 2017 Verma, Giri, Bhatt, Amador-Ortiz and Armitage.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Bone marrow (BM) biopsy of a case with synchronous chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia (SLL) and hairy cell leukemia (HCL). (A–D) BM core biopsy specimen showing an abnormal lymphoid infiltrate with a diffuse growth pattern. The infiltrate is positive for CD20 (B), and negative for CD5 and CD23 [(C,D), respectively], consistent with involvement by HCL. The CLL infiltrate is focally present in the core biopsy (1% of the BM space; data not shown). (E) The corresponding flow cytometric analysis shows two distinct monoclonal populations: a CD20 dim+, CD5+, CD103−, CD11c−, lambda restricted CLL/SLL population (in blue) and a CD20 bright+, CD5−, CD103+, CD11c+, lambda restricted HCL population (in red). The HCL population is also positive for CD25 (data not shown).