A 65 year old female with a history of treated Thyroid cancer presented her self at ER with a WBC of 150,000/mm3. Upon performing a leukemia panel, we found out that there were two distinct populations: The first population about 15% of the total nucleated cells was bright CD45, and positive for CD19, CD20, CD22, CD23, CD10, CD5, KAPPA, Cyclin D1, and FMC7. There was no staining with other T or Myeloid markers. The second population about 85% of total nucleated cells was dim CD45, and positive for CD19, CD10, CD22, CD34, TdT, Cytoplasmic IgM, dim CD20. Negative for light chains,CD23,CD5, CyclinD1, and FMC7. My question here, am I dealing with two separate clones one lymphoma and another is leukemia, or actually one clone that is in transformation? If it is the case in the later scenario, in which direction is the transformation moving (i.e. lymphoma to leukemia or vice versa) and would it make any difference to the patient in term of treatment and prognosis??? Any ideas and suggestions are welcome. Thanks in advance. Faisal Rawas Flow Cytometry Lab King Faisal Hospital Riyadh, KSA ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com
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