Dear Mrs Liu,
I have not seen or heard about a neuroblastoma positive for CD34. CD56 is
normally positive.
I see no argument against an AML FAB M7 (megakaryocytic leukemia). The
morphology is never like normal megakaryocytes, the blasts often show blebs
(membrane extrusions often similar in size to platelets). The phenotype
reported fits well with M7.
Marrow puncture is often hampered by punctio sicca.
Do you have digital video pictures in jpeg format to mail?
Regards
Thomas Nebe
Dr.med. C. Thomas Nebe
Universitaetsklinikum Mannheim
Zentrallabor
Theodor-Kutzer-Ufer 1-3
D-68167 Mannheim
Tel. +49 621 383-3485
FAX +49 621 383-73 3485
+49 621 383-3819
e-mail: thomas.nebe@ikc.ma.uni-heidelberg.de
Bitte besuchen Sie unsere informativen Webseiten unter
http://www.ma.uni-heidelberg.de/inst/ikc/
> -----Original Message-----
> From: Liu, Te Chih [SMTP:liutc@pacific.net.sg]
> Sent: Monday, February 21, 2000 7:08 AM
> To: Cytometry Mailing List
> Subject: ? neuroblastoma or Megakaryocytic leukaemia
>
>
> I've a clinical puzzle. 2 year old boy presenting with severe
> thrombocytopenia, platelets 21x10^9/l, Hb 10.9g/dl, WBC 16x10^9/L.
> Clinically, the child is well without any organomegaly. The peripheral
> blood
> film shows a few blasts with some other atypical, large immature
> mononuclear
> cells.
>
> An acute Lymphoblastic Leukaemia was the clinical suspicion and a marrow
> exam was done. This was moderately hypercellular with preserved normal
> haematopoiesis but scanty megakaryocytes. There were a number of the same
> atypical MNC appearing singly as well as in groups. The morphologic
> appearance suggested a neuroblastoma. Cytochemical stains were all
> negative.
> The trephine biopsy also suggested a neuroblastoma. There is however no
> evidence of a extramedullary tumour and catecholamines are not raised.
>
> The cells in the peripheral blood were flowed with the following results.
> 13% of peripheral blood cells were CD45 negative or very dim (dimmer than
> grans and similar to erythroblasts). They were CD34+/19 dim/33 dim/ 56
> dim/
> Tdt - / cy MPO - / 61+ / 42a +/ Glycophorin-A -. Fluoresence microscopy
> confirmed the CD42a & CD61 results.
>
> Are these then megakaryoblasts, undifferentiated blasts or neuroblastoma
> cells? There have been reports from Germany that neuroblastoma cells
> express
> the CD34 marker. Any opinions?
>
> Te-Chih.
>
> Liu, Te-Chih MD
> Laboratory Haematology
> National University Hospital
> Singapore 119074
> Tel: (65) 7725353
> Fax: (65) 7751757
>
>
>
> << Datei: ATT01787.ATT >>
This archive was generated by hypermail 2b29 : Sat Mar 10 2001 - 19:31:08 EST