Hairy cell leukemia
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Indolent B-cell neoplasm, abbreviated HCL. Named for the appearances on peripheral blood smears.
- Due to the biology, dry taps are common.[1]
Clinical:[2]
- Pancytopenia. Monocytopenia common in earlier disease.
- Splenic enlargement.
- No lymphadenopathy.
- Good prognosis (with treatment), though (likely) not curable.
Gross
Features:[3]
- Huge beefy red spleen.
- Red as white pulp obliterated.
Microscopic
Features:[4]
- 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"[5]) -- key feature.
DDx:
Images
HCL - blood film. (WC)
HCL - high mag. (WC)
HCL - very high mag. (WC)
www:
- HCL - bone marrow (nlm.nih.gov) from Holland-Frei Cancer Medicine (nlm.nih.gov).
- HCL - several images (upmc.edu).
- HCL - another case with several images (upmc.edu).
- HCL in the spleen (webpathology.com).
IHC
Features:[6]
- 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.
- ↑ Galani, KS.; Subramanian, PG.; Gadage, VS.; Rahman, K.; Ashok Kumar, MS.; Shinde, S.; Mahadik, S.; Ansari, R. et al. "Clinico-pathological profile of Hairy cell leukemia: critical insights gained at a tertiary care cancer hospital.". Indian J Pathol Microbiol 55 (1): 61-5. doi:10.4103/0377-4929.94858. PMID 22499303.
- ↑ URL: http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022. Accessed on: 20 August 2010.
- ↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 326. ISBN 978-1416054542.
- ↑ URL: http://emedicine.medscape.com/article/200580-diagnosis. Accessed on: 18 August 2010.
- ↑ URL: http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022. Accessed on: 20 August 2010.
- ↑ URL: http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A34022&rendertype=table&id=A34029. Accessed on: 20 August 2010.