Morphologic aspects of CD4⁺CD56⁺ tumor cells.

May-Grunwald staining of bone marrow smears. (A) Patient 1. (B) Patient 2. (C) Patient 8. (D) Patient 4. (E) Patient 12. (F) Patient 9. (G) Patient 17. (H) Patient 10. CD4⁺CD56⁺ tumor cells may correspond to small cells with a nucleus of a regular shape, a lacy chromatin, and a high nucleus/cytoplasm ratio (A and B). Cells may be larger with still a lacy chromatin and with a regularly shaped (C and D) irregular or indented (E) nucleus. The chromatin often presents a typical blastic appearance (F-H). Nucleoli are often clearly visible (A, C-E, G, and H). The size of blast cells may be heterogeneous (E and F). Tumor cells often display cytoplasmic vacuolation arranged as a pearl necklace along the cytoplasmic outline (C and D) or forming microvacuoles giving a heterogeneous aspect to the cytoplasm (F-H). Pseudopodialike membrane expansions are also frequent (F-H). Dysplastic features may be noted (A and D). Magnification, × 1000.