R: difficult diagnosis

From: Adriano Venditti (avenditti@mail.pelagus.it)
Date: Wed Feb 04 1998 - 15:36:53 EST


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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