Hairy Cell Leukemia

Composed of small B- lymphocytes with abundant cytoplasm and fine (hairy) cytoplasmic projections. Peripheral B-cell of the post germinal center stage (memory B-cell).

Morphology and Immunophenotype

Predominantly found in the bone marrow and red pulp of the spleen. Low number of neoplastic B-cells is seen in the peripheral blood. Lymphnode involvement is rare. Bone marrow involvement is subtle with preservation of normal hematopoiesis. As a result of the fibrogenic cytokines by the leukemic cells, a bone marrow biopsy shows an increase in reticulin fibers.

Morphology and Immunophenotype

Characteristic cytology of neoplastic cells is best appreciated in bone marrow aspirate and peripheral blood smears. Neoplastic cells display an indented nucleus, abundant cytoplasm, and fine hair-like cytoplasmic projections.

Hiiry Cell

 Classic hairy cell leukemia shows strong positivity for B-cell markers (CD19, CD20, CD22) coupled with bright expression of CD11c, CD25 and CD103. Tartrate resistant acid phosphatase and DBA44 are used.

Clinical Features
Rare lymphoproliferative disorder occuring in middle-aged individuals. Patient presents splenomegaly and pancytopenia. Durable remission can be achieved using interferon orpurine analogs Conventional lymphoma therapy is not effective.