Hand-mirror cells have also been reported with many diagnostic entities including cutaneous natural killer cell lymphomas [13], Anaplastic Ki-1 lymphomas [14], acute lymphoblastic leukemia [15], Burkitt's lymphoma [17], other B-Cell lymphomas with surface IgM-lambda [18], and with granulocytic and acute myelomonocytic leukemia [21]. Here, CD40LG is linked to acute lymphoblastic leukemia.