HCL - Slide 1
Cells of a 40-year-old man with hairy cell leukemia. Upon arrival the patient was found to be leukopenic (
2.2⋅109/L
). Two types of lymphocytes were noted during microscopic differentiation. On the one hand, the classic, hairy lymphocytes. On the other hand, lymphocytes that look like a fried egg, with a round, centrally located nucleus with leached, pale cytoplasm. HCL almost always causes monocytopenia.
Bands
Segments
Eosinophils
Lymphocytes
Erythroblasts
XN Scatterplots
Lymphocytes
Monocytes
Neutrophils & Basophils
Eosinophils
Leukocytes
Basophils
NRBCs
Debris
Erythrocytes
Reticulocytes
RBC fragments
Platelets
immature platelets
Immunophenotype
CD19+
CD5-
CD10-
CD20++
CD22++
CD23-
CD25+
CD11c+
CD103+
Kappa+
Hairy cells have a ragged cytoplasm, which gives them a relatively high side scatter. These malignant cells are mature B lymphocytes and therefore CD19 and CD20 positive. The predominant expression of Kappa reveals a monoclonal population. Strong expression of CD11c, CD22 and CD200 is suggestive of HCL. The combined expression of CD25 and CD103 is quite unique to HCL.
SSC
CD19
Lambda
Kappa
CD20
CD10
CD22
CD103
CD23
FMC7
CD25
CD11c
CD200
CD5
Peripheral blood
Hairy cells
Hairy cells
