HCL?Interesting case

From: ricardo morilla (ricardo@icr.ac.uk)
Date: Mon Feb 05 2001 - 08:23:34 EST


Dear Maryalice,
This CD103 positive interesting case may be a case of Hairy
Cell Leukaemia - Variant.
We have not seen CD103 expression on PLL,
but your results are consistent with a HCL-V, the nucleous
in HCL-V may look like a B-PLL and the villi may have been
"lost" because the smear is not fresh.
BM trephine histology will give more information and help
in the diagnosis.
Ricardo.


On Fri, 2 Feb 2001 11:00:27 -0500 Maryalice
Stetler-Stevenson <stetler@box-s.nih.gov> wrote:

>	We have a very interesting case. An 80 year old gentleman
> with a WBC= 47 K/uL and a working diagnosis of CLL sought another
> opinion. We found his tumor cells to be negative for CD5 and CD23.
> They had Bright CD19, CD20, CD22 and surface kappa. They were
> positive for CD103, FMC7 & and CD11c, although the CD11c was not the
> bright staining characteristic of hairy cell and CD25 was negative.
> Also- cells were negative for CD38 and CD10 but + for CD79 and CD24.
> The specimen was a submitted heparinized tube- no fresh smear. We
> have found that cells sitting in heparin for awhile have poor nuclear
> features after smearing and staining. However, the cells have copius
> cytoplasm. Borders may be curled, indistinct, possibly hairy but
> maybe not. We feel that this is most consistent with atypical hairy
> cell. The diagnosis of CLL was never confirmed by immuno studies-
> just a low grade lymphoid leukemia- and I feel the diagnosis is
> wrong. The clinician asked if this could be PLL. Has any one ever
> seen really good staining with CD103 in PLL?
>
>
>	Maryalice
>
> Maryalice Stetler-Stevenson
> Director Flow Cytometry Unit
> Laboratory of Pathology, NCI, NIH
>
> "Learn the rules so you know how to break them properly."
> The Dalai Lama


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Mr. Ricardo Morilla
Academic Department of Haematology & Cytogenetics
The Royal Marsden Hospital
203 Fulham Road, London  SW3 6JJ, UK

Tel    +44 (0) 20  7808 2882;  Fax    +44 (0) 20 7351 6420
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