title: An assessment of the usefulness of immunohistochemical stains in the diagnosis of hairy cell leukemia.
abstract: Annexin-1 and T-bet are recently described immunohistochemical stains that reportedly assist in the diagnosis of hairy cell leukemia (HCL). Our objective was to assess the sensitivity and specificity of a panel of immunohistochemical stains in distinguishing HCL from other B-cell neoplasms, particularly splenic and extranodal marginal zone lymphomas (SMZL and ENMZL, respectively). The study included 234 bone marrow biopsy specimens: 101 HCL, 13 SMZL, and 10 ENMZL cases were assessed with CD20, tartrate-resistant acid phosphatase (TRAP), DBA.44, a-1, T-bet, and cyclin D1, and 110 control cases were assessed with annexin-1 and T-bet. Our study showed that annexin-1 is a specific and sensitive marker for HCL; however, interpretation is limited by positivity within myeloid precursors. T-bet, DBA.44, and TRAP immunohistochemical stains lack sufficient sensitivity and specificity to differentiate HCL from either form of marginal zone lymphoma. However, our data suggest that the addition cyclin D1 to the immunostaining panel will increase the sensitivity and specificity of HCL diagnosis.
authors.affiliation: Dept of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sherman
authors.forename: Curtis A
authors.initials: CA
authors.lastname: Hanson
authors.forename: James D
authors.initials: JD
authors.lastname: Hoyer
mesh_terms: D000135:Acid Phosphatase / Q000378:metabolism; D017302:Annexins / Q000378:metabolism*; D018951:Antigens, CD20 / Q000378:metabolism; D001853:Bone Marrow / Q000378:metabolism*; D019938:Cyclin D1 / Q000378:metabolism; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D007527:Isoenzymes / Q000378:metabolism; D007943:Leukemia, Hairy Cell / Q000175:diagnosis* / Q000378:metabolism; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000378:metabolism; D012680:Sensitivity and Specificity; D020825:T-Box Domain Proteins / Q000378:metabolism*; D000071681:Tartrate-Resistant Acid Phosphatase; D000098815:T-bet Transcription Factor
chemical_list: D017302:Annexins; D018951:Antigens, CD20; D007527:Isoenzymes; D020825:T-Box Domain Proteins; D000098815:T-bet Transcription Factor; D019938:Cyclin D1; D000135:Acid Phosphatase; D000071681:Tartrate-Resistant Acid Phosphatase