Leukemia & Lymphoma, June 2011; 52(S2): 14–17
Surface topography of hairy cell leukemia cells compared to other leukemias as seen by scanning electron microscopy
AARON POLLIACK1 & TAMAR TADMOR2
1Department of Hematology, Hadassah University Hospital, Hebrew University Medical School, Jerusalem, Israel and 2Hematology–Oncology Unit, Bnai-Zion Medical Center, Haifa, Israel
Abstract This short review deals with the ultrastructural surface architecture of hairy cell leukemia (HCL) compared to other leukemic cells, as seen by scanning electron microscopy (SEM). The development of improved techniques for preparing blood cells for SEM in the 1970s readily enabled these features to be visualized more accurately. This review returns us to the earlier history of SEM, when the surface topography of normal and neoplastic cells was visualized and reported for the first time, in an era before the emergence and use of monoclonal antibodies and flow cytometry, now used routinely to define cells by their immunophenotype. Surface microvilli are characteristic for normal and leukemic lymphoid cells, myelo-monocytic cells lack microvilli and show surface ruffles, while leukemic plasma and myeloma cells and megakaryocytes display large surface blebs. HCL cell surfaces are complex and typically ‘hybrid’ in nature, displaying both lymphoid and monocytic features with florid ruffles of varying sizes interspersed with clumps of short microvilli cytoplasm. The surface features of other leukemic cells and photomicrographs of immuno-SEM labeling of cells employing antibodies and colloidal gold, reported more than 20 years ago, are shown.
Keywords: Hairy cell leukemia (HCL), scanning electron microscopy, leukemia, ultrastructure
Introduction Newer developments in the techniques of prepara- tion of cells for scanning electron microscopy (SEM) in the 1970s, including the entry of critical point drying techniques which replaced the conventional air drying methods, enabled the recording of novel data on the true surface architecture of different leukocytes, revealing their more dynamic interactive surface architecture [1–5]. Different leukocytes and leukemic cells could now be distinguished on the basis of their surface microstructures [1–5]. For the sake of brevity all references are not given and are restricted to a few, and we utilize the atlases from the 1980s as the major references for this review [1–14]. Examples of the cells as seen by SEM [1–5,10–14] and identified positively using immuno-SEM tech- niques are included [6–9].
Surface microstructures on normal and leukemic cells: definitions and descriptions
The different forms of surface features are limited in type and illustrated below. Essentially they were
defined as either finger-like microvilli, folds of surface membrane which were larger, broader, more irregular, and expansive, termed ruffles, and large bleb-like excrescences generally. Cells moved by the creation of polarized microvilli and uropods, while during attachment they spread by the develop- ment of thin transparent veils of cytoplasm and elongated filipodia. Lymphocytes had prominent microvilli, and the
initial exciting impressions that T cells had fewer microvilli than B lymphocytes was shown to be partially artifact. On the other hand, granulocytes consistently had raised ridge-like surface folds and small ruffles, while monocytes had characteristic and more expansive, ruffled folds generally lacking the typical microvilli noted on lymphoid cells [4,5,10– 12].
Surface architecture of leukemic and myeloma cells: obvious surface architectural differences
The differences evident on normal cells were also readily seen in their leukemic counterparts [4,5], after the examination of hundreds of cases. It was also
Correspondence: Aaron Polliack, Department of Hematology, Hadassah University Hospital, Hebrew University Medical School, Jerusalem, Israel. E-mail:
apol@cc.huji.ac.il
ISSN 1042-8194 print/ISSN 1029-2403 online 2011 Informa UK, Ltd. DOI: 10.3109/10428194.2011.565095
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