Memorias del Instituto de Investigaciones en Ciencias de la Salud
versão On-line ISSN 1812-9528
FIGUEREDO THIEL, SJ. Anatomopathological diagnosis of hairy cell leukemias in Paraguay. Mem. Inst. Investig. Cienc. Salud [online]. 2003, vol.2, n.1, pp. 05-19. ISSN 1812-9528.
Hairy cell leukemia or tricholeukemia is an entity within chronic lymphoproliferative syndromes with own characteristics different from those of other lymphoid neoplasias. It is a chronic leukemia characterized by an indolent and long clinical course, marked splenomegaly, pancytopenia and presence of characteristic hairy lymphocytic cells in peripheral blood, bone marrow and spleen. The diagnosis of this disease is not always easy from the clinico-hematologic point of view because of its own characteristics that avoid good cytologic extractions for a correct visualization of its cells. Due to this, a diagnostic anatomopathological confirmation complemented with special techniques is necessary in most cases. The objective of this study is to describe the morphological aspects of this pathology from the anatomopathological point of view, in its biological and histological character with the different special techniques used currently for diagnosis in hematopathology in Paraguay. Findings were then correlated with hematologic clinics and laboratory, therapeutic schemes used, response and evolution of patients. The cytological and biopsy materials were analysed in the Section of Hematologic Pathology, Department of Pathology, Health Sciences Research Institute (IICS, National University of Asuncion), during five years, since its creation in 1997 to 2002, using enzymatic cytohistochemical techniques in cytologies and paraffin cuts, immunohistochemistry, transmission and scan electronic microscopy. These materials include samples from bone marrow biopsies, aspirates and imprints, peripheral blood, splenectomies and liver wedge of seven consecutive cases found in 53 patients with chronic lymphoproliferative syndrome of the main hospitals of the country. This work remarks the importance of pathological anatomy and its special techniques in hemotopathology, mainly the bone marrow biopsy, to achieve a certainty final diagnosis in hairy cell leukemias. It is possible to evidence morphological cell and tissue changes as well as alterations that confirm the diagnosis in first place, analyse the prognosis criteria in second place and finally evaluate the therapeutic response of these patients.
Palavras-chave : Leukemia; hairy cells; bone marrow biopsy.