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Summary
Hairy cell leukemia diagnosis can be challenging due to hypocellular marrows. Tartrate-resistant acid phosphatase (TRAP) staining of plastic-embedded marrow biopsy specimens is a valuable diagnostic tool.
Area of Science:
- Hematology
- Oncology
Background:
- Hairy cell leukemia (HCL) is a rare B-cell malignancy.
- Diagnosis can be complicated by hypocellular bone marrow, mimicking other conditions.
Observation:
- Peripheral blood or marrow aspirate confirmed HCL in 8 of 11 patients.
- Marrow biopsy was essential for definitive diagnosis in 3 patients.
- Marked hypocellularity was observed in 3 patients, necessitating biopsy for diagnosis.
Findings:
- Plastic-embedded marrow biopsy sections stained for tartrate-resistant acid phosphatase (TRAP) proved useful.
- Abundant TRAP-positive cells were identified in all HCL cases using this method.
- TRAP staining was essential for diagnosis in one patient with hypocellular marrow.
Implications:
- Hypocellularity is a notable feature in some HCL cases.
- TRAP staining of plastic-embedded marrow biopsies is a helpful, sometimes essential, diagnostic technique for HCL.