The Fried Egg LPD

https://twitter.com/MorphologyAmigo/status/1691049789750644736

Hairy Cell Leukaemia(HCL) is an Exam Favourite

Normally in FRCPath will come up in a long case as you can have a Pancytopenic presentation and then they throw in the infamous Fried egg Trephine or if they sometimes have to really cruel they may just give you certain classic Immunohistochemical stains which define this condition

So lets have a brief overview of HCL

• It is an uncommon lymphoid neoplasm

• Characterised by the accumulation of small mature B cell lymphoid cells with abundant cytoplasm and "hairy" projections within the peripheral blood, bone marrow, and splenic red pulp

• It is an indolent lymphoid malignancy

• 80% of Patients present with Pancytopenia

Blood film below (cant get any hairy then this - this is not all the time but mostly yes ) - Remember if you have Pancytopenia and you cant find anything of note - Always go into the thick part of the film and have a look - Your Answer might be there :) - Also Monocytopenia is another Giveaway

On a Trephine - they say Classic is Fried Egg Appearance

But what exactly does that mean - have a look at the trephine Below