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Case 122 - Discussion

Hematopathology Case

 

 

CD2 CD20
CD3 CD4
CD43 CD56
CD68 LCA
  • The major differential diagnosis of this case includes "acute myeloid leukemia with monocytic differentiation", "blastic plasmacytoid dendritic cell neoplasm" and "NK/T cell lymphoma, nasal type". I do not have the information of other stains.

    1. Acute myeloid leukemia with monocytic differentiation: flow cytometry data would be very helpful, particularly expression status of CD14, CD34, CD64, CD123 and MPO;

    2. Blastic plasmacytoid dendritic cell neoplasm: again flow cytometry data would be very helpful. In addition, immunostains for CD123, TCL1 and TdT can be useful. Tumor cells typically express CD68 with cytoplasmic dotted pattern;

    3. NK/T cell lymphoma, nasal type: not likely since NK/T-cell lymphoma should be positive for CD3 by immunostaining. Again, flow cytometry for cCD3 would be helpful. Also, EBER-ISH is usually positive.