Dear Ugo, providing that cytochemical reactions are negative as I suppose, I would favor a diagnosis of undifferentiated acute leukemia. In fact, I do not believe that 1% MPO positive cells is enough to suggest a diagnosis of minimally differentiated acute myeloid leukemia. Adriano Venditti Cattedra di Ematologia - Università di Roma "Tor Vergata" Osp.S.Eugenio - Roma -----Messaggio originale----- Da: Ugo Consoli <uconsoli@mbox.vol.it> A: Cytometry Mailing List <cytometry@flowcyt.cyto.purdue.edu> Data: mercoledì 4 febbraio 1998 20.56 Oggetto: difficult diagnosis > >Dear flow friend >we have a 38 y/o woman whose diagnosis is challenging us. >She was admitted in our hospital for deep anemia (6 gr/dl) and low >platelets count (15000 mmc) discovered during a routine blood test after an >antibiotic resistant fever. >Clinically the patient has and enlarged spleen (4 cm below the costal >arch), an enlarged mediastinum caused by the presence of several >lymphonodes, and a pleural effusion. >The blasts looks like small undifferentiated cells and we have found >several figures of emophagocitosis. >The immunophenotype of the cells is: >CD7 positive (strong) >CD5 positive (dim) >CD45 positive (dim) >Gly-A positive (dim in 35% of the cell, but this monoclonal sometimes give >us questionable results!) >all the other markers we have tested are negative including: >CD2, cCD3, sCD3, CD4, CD8, CD9, CD10, CD11c, CD13, CD14, CD19, CD20, cCD22, >sCD22, CD33, CD34, CD36, CD41, CD42, CD117, DR. >Tdt is also negative as well as mieloperroxidase with the exxception of 1% >of the CD7 cells which are double positive for CD7 and MPO. > >Tomorrow we will stain our cells with CD1, MAC and few other MoAbs which >are positive on hystiocytes and macrophages but we are anxious to have >some clues from the discussion group. > >Cytogenetic is on the way. > >Thank you for your advices. >------------------------------------------ >Ugo Consoli, M.D. >Institute of Hematology >University of Catania, Italy >Fax ++39-95-7311510 >Tel. ++39-95-7435917 - 7435922 > > >
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