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History: 57 yo woman who presented with a high grade non-Hodgkin's
lymphoma involving an axillary lymph node that was eventually read as small
non-cleaved non-Burkitts. The spleen, liver and bone marrow were involved.
The malignant cells in the bone marrow were classic for small non-cleaved
(even classic for Burkitts). The cells in the lymph node were obviously
high grade but the pathologist signing out the node was leaning towards
Large cell lymphoma untill I showed him the bone marrow. We never got to
immunophenotype the cells before she was blasted with heavy duty
chemotherapy. The bone marrow became hypocellular with few B-cells and
remained so. There was a good response but then the patient relapsed in the
CNS.
Now she has 8 % tumor cells in the peripheral blood. They are + for
lambda light chains, CD19, CD20, CD22, CD38, HLADR, and CD10(very dim). Now
the unusual part- they are also CD5+, dim CD45 (like an ALL or AML), CD36+
(Fairly bright), very dim CD15+ and have heterogeneous expression of CD16
(approximately 50% +CD16).
I'm not sure this is a small non-cleaved lymphoma anymore. One of
my smartest friends suggested this might have been a CLL that transformed
before diagnosis. What do you think?
Maryalice
Maryalice Stetler-Stevenson
Director Flow Cytometry Unit
Laboratory of Pathology, NCI, NIH
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CD-ROM Vol 3 was produced by Monica M. Shively and other staff at the
Purdue University Cytometry Laboratories and distributed free of charge
as an educational service to the cytometry community.
If you have any comments please direct them to
Dr. J. Paul Robinson, Professor & Director,
PUCL, Purdue University, West Lafayette, IN 47907.
Phone: (765)-494-0757;
FAX(765) 494-0517;
Web
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CD-ROM Vol 3 was produced by Monica M. Shively and other staff at the
Purdue University Cytometry Laboratories and distributed free of charge
as an educational service to the cytometry community.
If you have any comments please direct them to
Dr. J. Paul Robinson, Professor & Director,
PUCL, Purdue University, West Lafayette, IN 47907.
Phone: (765)-494-0757;
FAX(765) 494-0517;
Web