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Case 24 - Discussion

Hematopathology Case

FLOW CYTOMETRY INTERPRETATION

 

Specimen: Peripheral Blood

The dim-CD45 positive blasts account for about 70% of peripheral blood cells. They are positive for CD13, CD33, CD34, CD71, and CD117. Aberrant expression of CD79a is noted.

			H gate Dim CD45+ 	A gate Bright CD45+
   Total events         events = 10936          events = 2522
   analyzed = 26181    (42% of total)	       (10% of total)
     
  CD45+/CD14-		     99%		     99%
  Total CD13+		     67%
  CD34+/CD13+		     63%
  Total CD15+		     25%
  CD34+/CD15+		     24%
  Total CD33+		     96%
  CD34+/CD33+		     90%
  Total CD34+		     93%
  CD11b+		     82%
  Total CD41+		     <2%
  CD34+/CD71+		     89%
  CD34+/CD117+		     92%
  Total HLA DR+		      2%
  CD34+/HLA DR+		      2%
  cCD3+			      4%
  cCD79a+		     61%
  cMPO+			     13%

 

Specimen: Bone marrow aspirate.

The blasts express dim CD45, CD11b, CD13 (subset), CD33, CD34, CD38, CD71, and CD117, and are negative for CD10, CD14, CD15, CD19, CD20, CD41, and HLA-DR.
 

 Total events     H gate Dim CD45+    A gate Bright
 analyzed= 50688    events= 36033      CD45+ events = 3028
                    (76% of total)    (6% of total)

   CD45+/CD14-          99%         95%
   Total CD14+          <2%
   Total CD13+          30%
   CD34+/CD13+          29%
   Total CD15+          4%
   CD34+/CD15+          4%
   Total CD33+          99%
   CD34+/CD33+          98%
   Total CD34+          99%
   CD11b+               73%
   Total CD41+          7%
   CD34+/CD71+          97%
   CD34+/CD117+         97%
   Total HLA DR+        6%
   CD34+/HLA DR+        6%
   Total CD19+          <2%         7%
   CD19+/CD20+          <2%         7%
   Total CD38+          98%         94%
   CD19+/CD38+          <2%         7%
   CD19+/CD10+          <2%         <2%

CYTOGENETICS (UNMC, Cytogenetics)

 

Normal male karyotype: 46,XY[20]

CYTOCHEMICAL STAINS

 

MPO: Positive in 1-2% of the blasts.
Non-specific esterase: Negative in the blasts

DIAGNOSIS

 

Acute myeloid leukemia