Acute lymphoblastic leukemia, hand-mirror variant. A detailed ultrastructural study

Area of Science:

• Hematology
• Cell Biology
• Immunology

Background:

• Hand-mirror cells in acute lymphoblastic leukemia (ALL) possess potential immunologic, pathogenic, and prognostic significance.
• Understanding the ultrastructure of these cells is crucial for elucidating their role in leukemia.

Purpose of the Study:

• To conduct a detailed ultrastructural analysis of hand-mirror cells in acute lymphoblastic leukemia.
• To compare the ultrastructure of hand-mirror cells with classic lymphoblasts.

Main Methods:

• Electron microscopy was used to analyze lymphoblasts from an untreated ALL patient with numerous hand-mirror cells.
• Fifty electron micrographs of hand-mirror cells were compared with 60 micrographs of lymphoblasts from six ALL patients.

Main Results:

• Hand-mirror cells exhibited unique ultrastructural features, including intact mitochondria and uropods with microspikes containing organized microfilaments.
• Significant quantitative differences were observed in nuclear and cytoplasmic dimensions, as well as nuclear-cytoplasmic ratios and mitochondrial counts between hand-mirror cells and classic lymphoblasts (P < 0.0001 for most).

Conclusions:

• The ultrastructure of hand-mirror cells suggests involvement in cell motility and immunologic processes.
• These findings indicate a potential association between hand-mirror cells and immunologic mechanisms in leukemogenesis.