+ = most cases are positive for the antigen; - = most cases are negative; +/- = cases are variably positive; CLL = chronic lymphocytic leukemia; PLL = prolymphocytic leukemia; HCL = hairy cell leukemia; sIg = surface immunoglobulin.

lack of male preponderance, aspirable bone marrow with lack of fibrosis, and absence of monocytopenia. The neoplastic cells express surface immunoglobulins with Ig light-chain restriction as well as pan-B cell antigens CD19/20. They are negative for CD5, CD10, and CD25 antigens, while CD103 and CD11c may be positive. The bone marrow typically shows an interstitial infiltrate accompanied by an intrasinusoidal component. Similar to HCL, HCLv cells have a villous cytoplasm; however, they generally exhibit a more condensed chromatin, higher nuclear-to-cytoplasm ratio, and more pronounced central nucleoli than do the cells in patients with HCL Figure 30.5.71 TRAP staining of HCLv cells is negative.54 The biologic relationship between HCLv and HCL remains unknown.

Figure 30.5 Peripheral smear of a patient with hairy-cell variant, demonstrating abundant cytoplasm with irregular borders and visible nucleoli (in contrast to HCL)
Wilbrand Knee
Figure 30.6 Bone marrow trephine biopsy of a patient with splenic marginal zone lymphoma showing (a) focal lymphoid aggregates and (b) immunostaining for CD20 delineates intrasinusoidal and interstitial infiltration by lymphocytes
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