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Difference between revisions of "Hairy cell leukemia"
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[[File:Bone marrow infiltration by hairy cell leukaemia.jpg|thumb|High power magnification of a bone marrow trephine showing infiltration by hairy cell leukaemia.]] | |||
Indolent B-cell neoplasm, abbreviated ''HCL''. Named for the appearances on peripheral blood smears. | |||
[[ | *Due to the biology, ''dry taps'' are common.<ref name=pmid22499303>{{Cite journal | last1 = Galani | first1 = KS. | last2 = Subramanian | first2 = PG. | last3 = Gadage | first3 = VS. | last4 = Rahman | first4 = K. | last5 = Ashok Kumar | first5 = MS. | last6 = Shinde | first6 = S. | last7 = Mahadik | first7 = S. | last8 = Ansari | first8 = R. | last9 = Sengar | first9 = M. | title = Clinico-pathological profile of Hairy cell leukemia: critical insights gained at a tertiary care cancer hospital. | journal = Indian J Pathol Microbiol | volume = 55 | issue = 1 | pages = 61-5 | month = | year = | doi = 10.4103/0377-4929.94858 | PMID = 22499303 }}</ref> | ||
Clinical:<ref>URL: [http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022 http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022]. Accessed on: 20 August 2010.</ref> | |||
*Pancytopenia. Monocytopenia common in earlier disease. | |||
*Splenic enlargement. | |||
*No lymphadenopathy. | |||
*Good prognosis (with treatment), though (likely) not curable. | |||
===Gross=== | |||
Features:<ref name=Ref_PCPBoD8_326>{{Ref PCPBoD8|326}}</ref> | |||
*Huge beefy red [[spleen]]. | |||
**Red as white pulp obliterated. | |||
===Microscopic=== | |||
Features:<ref>URL: [http://emedicine.medscape.com/article/200580-diagnosis http://emedicine.medscape.com/article/200580-diagnosis]. Accessed on: 18 August 2010.</ref> | |||
*Small cells (10-20 micrometers) with "Fried egg"-like appearance: | |||
**Well-demarcated fuzzy cell borders, | |||
**Clear/whispy cytoplasm and, | |||
**Central round nucleus. | |||
***Peri-nuclear clearing ("water-clear rim"<ref>URL: [http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022 http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022]. Accessed on: 20 August 2010.</ref>) -- '''key feature'''. | |||
DDx: | |||
*[[Hepatosplenic T-cell lymphoma]]. | |||
====Images==== | |||
<gallery> | |||
Image:Hairy_cell_leukemia.jpg | HCL - blood film. (WC) | |||
Image:Hairy cell leukemia - high mag.jpg | HCL - high mag. (WC) | |||
Image:Hairy_cell_leukemia_-_very_high_mag.jpg | HCL - very high mag. (WC) | |||
</gallery> | |||
www: | |||
*[http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022&rendertype=figure&id=A34027 HCL - bone marrow (nlm.nih.gov)] from [http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022 Holland-Frei Cancer Medicine (nlm.nih.gov)]. | |||
*[http://path.upmc.edu/cases/case240.html HCL - several images (upmc.edu)]. | |||
*[http://path.upmc.edu/cases/case691.html HCL - another case with several images (upmc.edu)]. | |||
*[http://webpathology.com/image.asp?case=380&n=3 HCL in the spleen (webpathology.com)]. | |||
===IHC=== | |||
Features:<ref>URL: [http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022&rendertype=table&id=A34029 http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022&rendertype=table&id=A34029]. Accessed on: 20 August 2010.</ref> | |||
*CD20 +ve, CD11c+ve, CD25 +ve, CD103 +ve, CD123 +ve, cyclin D1 +ve, DBA44 +ve | |||
*CD5 -ve. | |||
Flow cytometry: | |||
*CD19 +ve, CD11c +ve, FMC7 +ve. | |||