HCL Meeting 2010
evident thatmore immature leukemic cells appeared to have fewer surface projections. Lymphoid, myeloblas- tic, and monoblastic leukemias were readily distin- guished on the basis of their surface architectural patterns (Figures 1–3). Lymphoid leukemic cells had microvilli which weremost prominent on moremature B-lymphoid cells, while myeloid leukemic cells had ridges and small ruffles and leukemic monoblasts had larger and more prominent ruffles [4,5,12,13]. Plasma cell leukemia/myeloma cells and leukemic megakaryo- blastic cells were different, and showed prominent surface bleb formations and did not display surface microvilli (Figure 4).
Complex surface features of hairy cell leukemia cells
The first hairy cells examined were indeed very different from both lymphoid cells and monocytes and had more complex surface features, showing multiple surface ruffles and folds with clumps and clusters of short microvilli interspersed between them, creating the ‘hybrid’ appearance of a mix of lymphoid and monocytic features, typical and unique to hairy cells [4,5,14,15] (Figures 5–7). The special characteristic ‘hairy’ surface is also readily seen on light and phase microscopy. Hairy cell leukemia (HCL) cells are also able to phagocytose red blood cells (RBCs) or other particles and spread on to the underlying substrate, developing elongated filipodia and spreading cyto- plasmic veils during attachment on to their substrate (Figure 8). These irregular surface ruffles are readily seen on transmission electron micro- scopy (TEM) (Figure 9).
Figure 2. Myeloid leukemia cells showing typical surface ridges and ruffles.
15
Figure 3. Leukemic monoblast showing well developed ruffles.
Figure 1. Chronic lymphocytic leukemia cell showing multiple microvilli.
Figure 4. Plasma cell leukemia cell showing irregular blebs without microvilli.
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