Bone marrow and splenic histology in hairy cell leukaemia

Publication date: Available online 24 October 2015 Source:Best Practice & Research Clinical Haematology Author(s): Andrew Wotherspoon, Ayoma Attygalle, Larissa Sena T. Mendes Hairy cell leukaemia is a rare chronic neoplastic B-cell lymphoproliferation that characteristically involves blood, bone marrow and spleen with liver, lymph node and skin less commonly involved. Histologically the cells have a characteristic appearance with pale/clear cytoplasm and round or reniform nuclei. In the spleen the infiltrate involves the red pulp and is frequently associated with areas of haemorrhage (blood lakes). The cells stain for B-cell related antigens as well as with antibodies against tartrate-resistant acid phosphatase, DBA44 (CD72), CD11c, CD25, CD103, CD123, cyclinD1 and annexinA1. Mutation of BRAF –V600E is present and antibody to the mutant protein can be used as a specific marker. Bone marrow biopsy is essential in the initial assessment of disease as the bone marrow may be inaspirable or unrepresentative of degree of marrow infiltration as a result of the tumour associated fibrosis preventing aspiration of the tumour cell component. Bone marrow biopsy is important in the assessment of therapy response but in this context staining for CD11c and AnnexinA1 is not helpful as they are also markers of myeloid lineage and identification of low level infiltration may be obscured. In this context staining for CD20 may be used in conjunction with morphological assessm...
Source: Best Practice and Research Clinical Haematology - Category: Hematology Source Type: research