Chronic Lymphocytic Leukemia And Hairy Cell Leukemia

Chronic lymphocytic leukemia (CLL) and Hairy cell leukemia (HCL) Physical, radiological, cytological and histopathological aspects

CLL – physical aspects
Large, “soft”, non-compressive lymphadenopathy is typical of chronic lymphocytic leukemia (CLL).
CLL may also be associated with micropolyadenopathy or lymphadenopathy may be absent.

CLL – Physical aspects
Pallor and jaundice due to autoimmune hemolytic anemia in two cases of CLL.
Autoimmune hemolytic anemia in CLL is usually mediated by “warm”, IgG autoantibodies and may sometimes be extremely severe, even life-threatening.

Left lower eyelid epithelioma as a second cancer in a patient with a long history of chronic lymphocytic leukemia treated intermitently with alkylating agents (chlorambucil).
Second cancers are relatively frequent events in CLL, probably in relation with an intrinsic immune defect as well as to the mutagenic effects of alkylating agents.

Cutaneous leukemic infiltrate in a case of chronic lymphocytic leukemia (upper image)
Immune mediated necrotizing vasculitis in a case of CLL (lower image).

CLL – radiological aspects
Osteoporosis and patches of osteolysis in a case of CLL.
Rarely, CLL may be associated with multiple, multiple myeloma-like osteolytic lesions.

CLL – cytological aspects
High number of lymphocytes with a mature appearance on the peripheral smear of a CLL patient.
“ Shadow cells” of Gumprecht (the element in the lower part of the image) are typical for CLL peripheral smear consisting in fact of lymphocyte nuclei, crushed during smear preparation

CLL – histopathological aspects
Small lymphocyte bone marrow infiltration in two cases of CLL:
nodular pattern of infiltration (upper image)
diffuse pattern of infiltration (lower image).

CLL – histopathological aspects
Typical immunohistochemical CLL aspect:
Double positivity for CD20 (upper image) and CD5 (lower image).

Hairy cell leukemia (HCL) – cytological aspects
The typical “hairy” aspect, with cytoplasmic elongated protrusions in HCL.
The presence of “hairy” cells on the peripheral smear is usually associated with various degrees of pancytopenia.

Hairy cell leukemia (HCL) – histopathological aspects
Bone marrow biopsy in a case of HCL: a sparse, “aerated” lymphoid infiltrate, along with various degrees of myelofibrosis is characteristic.

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Chronic Lymphocytic Leukemia And Hairy Cell Leukemia

by balsan on Sep 28, 2009

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Chronic Lymphocytic Leukemia And Hairy Cell Leukemia — Presentation Transcript