The following, in my book, qualifies this as hairy cell variant: 1. 1. Morphology is atypical >(TRAP is positive in these cells but morphologically they are not quite classical hairy cells.) 2. They are CD25 negative (CD25 is + in 97% of typical HCL and + in 0% of vHCL 3. There is weak to moderate staining for FMC7- 91% + in HCL and 73%+ in vHCL 4. CD10 is + in 5% of typical HCL and in 21% of vHCL The most important point is that it doesn't look like typical HCL. Maryalice >With the exception of not staining for CD25, everything else fits for >typical hairy cell leukemia (older gentleman, dry tap on marrow, >pancytopenia). Although CD10 is not common, it has been well-described in >otherwise typical hairy cell. What qualifies this as a so-called hairy cell >variant? > >Christopher S. Bee, M.D. >Medical Director, Cellular Immunology and Flow Cytometry >Wilford Hall Medical Center >Lackland AFB, Texas >(210) 292-5455 >DSN 554-5455 >christopher.bee@59mdw.whmc.af.mil > >-----Original Message----- >From: Maryalice Stetler-Stevenson [mailto:stetler@box-s.nih.gov] >Sent: Tuesday, February 13, 2001 8:19 AM >To: Cytometry Mailing List >Subject: Re: HCL variant vs. ? > > > >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 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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