Hairy cell leukaemia

Autor*: Monika Antošová, A. Buliková, J. Kissová

Description:
72- years old man hospitalised for long term severe pancytopenia (Hb 90 g/l, MCV 87 fl, platelets 20 G/l, leukocytes 0,77 G/l) and splenomegalia. Bone marrow smears shows infiltration of hairy cell leukemia. Diagnosis is confirmed by histologic examination of bone marrow biopsy including TRAP a HCL imunochemistry and by flow cytometry.

Zařazení*:
Hairy cell leukaemia

Přílohy*:

Hairy cell leukaemia- PB
Some hairy cell can remind monocyte, but cytoplasm is pale blue in this case instead of grey in monocytes. On the other hand monocytopenia is typical sign in hairy cell leukemia. There is normal lymphocyte at upper right. / Některé vlasaté buňky mohou přípomínat monocyty, ale cytoplazma je v tomto případě světle modrá na rozdíl od šedé u monocytů. Naopak monocytopenie je typickou známkou u vlasatobuněčné leukémie. Nahoře vpravo je normální lymfocyt. Description: Some hairy cell can remind monocyte, but cytoplasm is pale blue in this case instead of grey in monocytes. On the other hand monocytopenia is typical sign in hairy cell leukemia. There is normal lymphocyte at upper right.
Type: peripheral blood
Klíčová slova*: hairy cell
Hairy cell leukaemia- BM
In this case of hairy cell leukemia smears shows unusually large tumour cells (usually medium-size), with irregular nucleus shape and/or cleft . Chromatin of the nucleus is spongy, less clumped than that of a normal lymphocyte. / V tomto případě vlasatobuněčné leukémie nátěry ukazují neobvykle velké nádorové buňky (obvykle střední velikosti). Jaderný chromatin je pórovitý, méně kondenzovaný nežli tomu je u normálního lymfocytu. Description: In this case of hairy cell leukemia smears shows unusually large tumour cells (usually medium-size), with irregular nucleus shape and/or cleft . Chromatin of the nucleus is spongy, less clumped than that of a normal lymphocyte.
Type: bone marrow
Klíčová slova*: hairy cell
Hairy cell leukaemia- BM
Smears of bone marrow aspirate use to be pure because aspiration is usually difficult or even impossible. Tumour cells can represent only minority cell population. Cells are the most often medium-size, but larger then normal lymphocyte. They have abundant weakly basophilic cytoplasm with irregular cytoplasmic margins. The cell at upper right contains few cytoplasmic inclusions. / Nátěry z aspirační biospie jsou obvykle chudé protože aspirace je většinou obtížná nebo dokonce nemožná. Nádorové buňky mohou představovat jen minoritní buněčnou populaci. Buňky jsou nejčastěji střední velikosti, ale větší než normální lymfocyt. Mají objemnou slabě basofilní cytoplazmu s nepravidelnými cytoplazmatickými okraji. Buňka vpravo nahoře obsahuje několik cytoplazmatických inkluzí. Description: Smears of bone marrow aspirate use to be pure because aspiration is usually difficult or even impossible. Tumour cells can represent only minority cell population. Cells are the most often medium-size, but larger then normal lymphocyte. They have abundant weakly basophilic cytoplasm with irregular cytoplasmic margins. The cell at upper right contains few cytoplasmic inclusions.
Type: bone marrow
Klíčová slova*: cytoplasmic inclusion, hairy cell
Hairy cell leukaemia- BM
Chromatin of nucleus is less condensed to compare normal lymphocyte in hairy cell. Abundant cytoplasm contains few discrete vacuoles and protrudes circumferential in "hairy" projections / Jaderný chromatin "vlasatých" buněk je méně kondenzován ve srování s normálním lymfocytem. Objemná cytoplazma obsahuje několik drobných vakuol a vybíhá do "vlasatých" výběžků po obvodu buňky. Description: Chromatin of nucleus is less condensed to compare normal lymphocyte in hairy cell. Abundant cytoplasm contains few discrete vacuoles and protrudes circumferential in "hairy" projections
Type: bone marrow
Klíčová slova*: hairy cell, lymphocyte atypical, vacuolisation
Hairy cell leukaemia- BM
Another example of hairy cell - oval nucleus, moderate mature chromatin, abundant weakly basophilic cytoplasm with few vacuoles, few inclusions and irregular margins with projections in all circumference of the cell. / Jiný příklad vlasaté buňky - oválné jádro, středně zralý chromatin, bohatá slabě basofilní cytoplazma s několika vakuolami, několika inkluzemi a nepravidelným ohraničením s výběžky po celéom obvodu buňky. Description: Another example of hairy cell - oval nucleus, moderate mature chromatin, abundant weakly basophilic cytoplasm with few vacuoles, few inclusions and irregular margins with projections in all circumference of the cell.
Type: bone marrow
Klíčová slova*: hairy cell, vacuolisation
Hairy cell leukaemia- BM
Nuclei of hairy cells may be round, oval, kidney or dumbbell shaped or bi-lobed. There is some condensation of chromatin, nucleoli are not apparent or incospicuous - like this case. / Jádro vlasatých buněk mohou být kulatá, oválna, ledvinovitého či činkovitého tvaru případně dvoujaderná. Chromatin je částečně kondenzován, jadérka nejsou přítomna nebo nezřetelná - jako je tomu v tomto případě. Description: Nuclei of hairy cells may be round, oval, kidney or dumbbell shaped or bi-lobed. There is some condensation of chromatin, nucleoli are not apparent or incospicuous - like this case.
Type: bone marrow
Klíčová slova*: hairy cell
Hairy cell leukaemia- BM
Hairy cells are characterised by strong positivity tartrate resistant acid phosphatase (TRAP). This finding can be proved in variable proportions of the cells. / Vlasaté buňky jsou charakterizovány silnou pozitivitou tartrát resistentní kyselé fosfatázy (TRAP). Tento nález může být prokázán v různé části buněk. Description: Hairy cells are characterised by strong positivity tartrate resistant acid phosphatase (TRAP). This finding can be proved in variable proportions of the cells.
Type: bone marrow
Klíčová slova*: hairy cell, tartrate resistant acid phosphatase stain
Hairy cell leukaemia- BM
TRAP positivity is diffuse in hairy cells or diffuse-granular. It's demonstration is important in confirming diagnosis. / Ve vlasatých buňkách je TRAP pozitivita difusní nebo difusně-granulární. Její průkaz je důležitý pro potvrzení diagnózy. Description: TRAP positivity is diffuse in hairy cells or diffuse-granular. It's demonstration is important in confirming diagnosis.
Type: bone marrow
Klíčová slova*: hairy cell, tartrate resistant acid phosphatase stain