Reassessment of a Cytochemical Test for Differential Diagnosis of Leukemic Reticuloendotheliosis

Abstract

Reports of negative tartrate-resistant acid phosphatase reactions in a few cases of leukemic reticuloendotheliosis prompted the authors to re-evaluate the diagnostic specificity of this test. As a result, they modified the test by (1) incorporating a dual-control system for excluding a false-negative test due to technical errors, and (2) instituting an objective grading system for assuring consistent interpretation of the test on blood smears. When these modifications were applied to materials of patients suspected to have leukemic reticuloendotheliosis, there was an excellent, although not specific, correlation between the positive test and the diagnosis of leukemic reticuloendotheliosis. Tartrate-resistant acid phosphatase reactions were positive, intermediate, and negative for 76, 21, and 3% of 29 patients who had leukemic reticuloendotheliosis, whereas the figures were 3, 32, and 65%, respectively, for 37 patients who had chronic lymphocytic leukemia and other hematologic disorders.

TIA-1 expression in hairy cell leukemia

“…Hairy cell leukemia, formerly known as leukemic reticuloendotheliosis, [25][26][27][28][29][30][31] is characterized by bone marrow 32 and splenic involvement by small to medium-sized neoplastic cells with abundant cytoplasm and hairy projections. [33][34][35] In our present study, hairy cytoplasmic projections were observed in the peripheral blood in most cases (7/9) by electron or phase-contrast microscopy.…”

“…34,35 Furthermore, TRAP was positive in most cases (5/7 cases studied). 26,31,34,35 In the bone marrows and spleens studied, neoplastic cells had a small to mediumsized, round nucleus and ample, pale cytoplasm. All patients had splenomegaly, and in some cases, blood lakes were observed by light microscopy.…”

Monoclonal antibodies with specificity for hairy cell leukemia cells.

“…Cells from 15 E rosettes. Spontaneous rosette formation between lymphocytes and neuraminidase-treated sheep erythrocytes was performed as described elsewhere (17).…”

“…Demonstration of tartrate-resistant acid phosphatase (TRAP) has been used extensively as a marker for hairy cells in both clinical (13) and experimental situations (7,14). This test, however, has been shown not to be totally specific for hairy cells (15), especially when results show intermediate positivity. HCL with a negative TRAP test has also been described (15).…”

“…This test, however, has been shown not to be totally specific for hairy cells (15), especially when results show intermediate positivity. HCL with a negative TRAP test has also been described (15).…”