Hairy Projections on Non Hairy Cells- A Case Report

Adult T-Cell Leukaemia/Lymphoma (ATLL) is a mature T-cell neoplasm. It is caused by human retrovirus Human T-cell Lymphotropic Virus Type 1(HTLV-1). The neoplastic cells after monoclonal integration begin to express T-cell associated antigens namely CD2, CD3 and CD5. These leukaemic cells are highly pleomorphic in light microscopic appearance and also they have a highly variable clinical presentation ranging from acute to lymphomatous to chronic to smouldering. There is a chance of missed or miss diagnosis due to their morphological and clinical heterogeneity and specialised test like immunophenotyping or flow cytometry is essential for exact categorisation. Authors hereby, report a case of 45-year-old female patient suffering from ATLL whose peripheral smear showed leukaemic cells with unusual hairy projections resembling hairy cell leukaemia posing diagnostic dilemma.

FEATURES OF THE EARLY PROCESS IN DIABETIC FOOT SYNDROME

Summary. Diabetic foot syndrome (DFS) is one of the most common surgical diseases. The aim of the study: to determine the features of the wound process in the DFS. Materials and methods. Multimodal pathomorphological study of biopsy material in 120 cases of surgical treatment of DFS was performed. Results and discussion. During the development of the wound process in the DFS, histologically determined reduction of edema, cellular infiltration, microcirculatory disorders in the marginal area of the wound in the dynamics of treatment. It is found in granulation tissue and in the dermis adjacent to intact skin, a large number of hairy cells. Microcirculatory disorders are expressed in the form of venular plethora, the phenomena of stasis in the capillaries, hemolysis of erythrocytes and the marginal standing of the formed elements in the venules and capillaries. The DFS is characterized by the appearance of foci of destruction and lysis of the newly formed epithelium, which is not observed in the normal wound process. Conclusions. The formation of granulation tissue is slow, mainly in the form of unformed connective tissue without the formation of classic granulations.

Unusual nuclear form hairy cells in hairy cell leukemia discovered using a lymphocyte-binding anti-CD antibody microarray.

Hairy cell leukemia (HCL) is a chronic lymphoproliferative disorder constituting about 2% from all leukemia cases and characterized by typical “hairy” morphology of tumor lymphocytes. We describe an HCL case with atypical nuclear shapes (lymphocytes with clover-leaf-like, horse-shoe-like, ring-shaped nuclei and binuclear cells were present). Morphology and immunophenotype of circulating leukemic cells were studied using a cell-binding microarray - a transparent plastic slide with immobilized monoclonal antibodies against surface antigens of lymphocytes. The cell-binding microarray with immobilized anti-CD11c, anti-CD103 and anti-CD123 permits to study a lymphocyte population enriched with hairy cells. Hairy cells with atypical nuclei constituted 3% of all lymphocytes and 15% of all hairy cells. This unusual hairy cell morphology is the first described in Russia and was found in one out of 85 HCL cases in our practice.

LEUKEMIA SEL BERAMBUT

Hairy cell leukaemia (HCL) is a neoplastic disorder of B lymphocytes originally described by Bouroncle et al. in 1958. HCL clinicalmanifestations varies, generally characterized by various degrees of splenomegaly, pancytopenia, or emphasis only on the two cell lines(bisitopenia), with the hairy cells in varying amounts in the peripheral blood smear and bone marrow. HCL is a very rare case, there areonly about 2% of all leukaemias more frequently in men than women (4:1) with the average age of disease onset between 50–55 years.The etiology of HCL is still not known. A case of HCL Leukaemia in a female patient, aged 55 years is reported which was a rare case.HCL diagnosis in this patient was based on the clinical manifestation (splenomegaly), and laboratory results (bisitopenia, neutropeniaand monositopenia) and about 80% hairy cells were found in peripheral blood smears. Definite diagnosis of HCL should be made by bonemarrow examination, immunophenotyping and cytogenesis.

Morphologic confounders and CD19 negativity in a case of hairy cell leukemia.

Objectives:We report a case of hairy cell leukemia (HCL) initially misdiagnosed as plasma cell dyscrasia due to various clinical, morphological and immunophenotypic confounders.Methods and results:In a patient diagnosed of marrow plasmacytosis and serum monoclonal protein elsewhere and referred to our hospital, morphological evaluation of bone marrow aspirate smears and trephine biopsy, immunophenotyping, and molecular testing (BRAFV600E mutation) were done. Clinically, the patient was asymptomatic, bone marrow revealed plasmacytosis, mastocytosis and lymphocytosis with a few “hairy” cells. Immunophenotyping revealed features of HCL with aberrant CD10 expression and a subclone of CD19neg cells. A diagnosis of HCL with reactive plasmacytosis and mast cell hyperplasia was made and confirmed by immunophenotyping and molecular studies.Conclusion:Hematopathologists must be aware of various confounding factors and should judiciously use flow cytometric and molecular studies for attaining a proper diagnosis of HCL. We also report a very rare immunophenotypic aberrancy (CD 19 negativity) in HCL