The final results on this interesting case:
Flow: +CD34, +CD13, +CD10 and +CD65
Parrafin: + CD15, +CD79a but cytoplasmic in a golgi pattern), +TDT,
- MPO, -CD20, -CD3, -CD5,- CD68, -CD4, -CD8,
Cytogenetics: 1 hyperdiploid cell out of 31 cells examined.
I feel this is more consistent with an AML-M0, especially since it
is arising in MDS and the CD13, CD65 and CD15 positivity. Basically though,
this is one of those fun "gray cases" that refuses to be fully white or
black.
Maryalice
> Anna and Maryalice,
> I think CD79a (and possibly c-kit) on paraffin is a good idea, but why
> the assumption that this is ALL? I think that an M0 AML arising from
> MDS (especially if there are background MDS changes) is more likely
> than a CD19 negative ALL arising from MDS. While CD10 expression is
> unusual in AML, we see it in 2.9% of our adult AML cases. Other than
> the unusual CD10 expression, the immunophenotype does not appear to
> exclude AML.
>
> Dan Arber, M.D.
> City of Hope
>
>
>______________________________ Reply Separator
>_________________________________
>Subject: Re: Interesting case
>Author: anpo@mb.ks.se (Anna Porwit-MacDonald) at INTERNET
>Date: 12/3/97 4:00 PM
>
>
>
>Hi Maryalice!
>I have seen CD65 on a couple of ALL`s, both in children.
>Did you try CD79a - works nicely on paraffin with double APAAP!
>If positive - confirms ALL!
>Best wishes
>Anna
>
>Anna Porwit-MacDonald MD, PhD
>Haematopathology Lab.,
>Karolinska Hospital
>Stockholm
> >
>>I recently had an interesting case. We received bone marrow on a 75 yo WF
>>with history of MDS. We noted immediately that she now has leukemia that is
>>+CD34, CD13, CD65 and CD10 but negative for CD33, CD71, CD11b, CD14, CD61,
>>CD41, CD42b, CD64, CD36, CD19, CD20, kappa, lambda, CD4, CD8, CD2, CD5,
>>CD16, CD56, and CD57. Unfortunately our MDS panel is set up to answer
>>protocol questions and doesn't have all leukemia antigens we would wish
>>(yes we have to worry about costs too). The blasts are weird, as expected
>>for MDS, and have scant cytoplasm, no granules and wild but small nuclei.
>>We then did some IP on the parrafin stuff and found the
>>following:myeloperoxidase -, Leu 22(CD43) + and Leu M1-CD15- weird spotty
>>+. TDT is pending. My question- Has any one seen CD65 on an ALL? What do
>>you think of this?
>>
>>
>> Maryalice
>>
>>Maryalice Stetler-Stevenson
>>Director Flow Cytometry Unit
>>Laboratory of Pathology, NCI, NIH
>>
>>
>>
>>
>
>
Maryalice Stetler-Stevenson
Director Flow Cytometry Unit
Laboratory of Pathology, NCI, NIH
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