This is an excellent example of variant hairy cell leukemia. The strong CD11c and 103 with bright CD22 and CD20 make the diagnosis. Depending on who you believe, CD103 is (according to my Hemepath gods) more specific than TRAP- which is positive in a number of NHL's. CD10 is found in some HCL. The dry tap goes with it. Was there a monocytopenia? Maryalice >A 64year old gentleman with pancytopenia (WBC: 2 K/uL, Hbg:8.0g%, >Plt: 80,000), found on a routine blood count. No infections, no >splenomegaly, "healthy". He comes from Chernoble and works as a >carpenter. Bone marrow aspirates twice were dry taps so a sample of >peripheral blood was sent for phenotyping. 20% of his lymphocytes >were strongly positive for CD103, CD22, CD19, CD20, Lambda, CD11c >and CD10 with only about 30% of the cells showing weak to moderate >staining for FMC7 They were negative for CD25 and CD38. TRAP is >positive in these cells but morphologically they are not quite >classical hairy cells. Can this be a HCL variant? Has anyone seen a >lymphoma with monoclonal B cells strongly positive for CD103 and >CD11c ? > >Judy > >Judith Chezar >Head Hematology and Blood Bank laboratories >Hospital of Western Galilee >Nahariya, Israel > 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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