Hi, Did you stain for CD138? Most plasma cell differentiating- B cell disorders are positive. Also, was kappa on the surface or only cytoplasmic? We have looked at many myeloma/immunocytoma cases and none was positive for CD34. Other myeloid- associated markers (CD13, CD33, CD117) do occur. Molecular study for IgH rearrangement should be of value. Kind regards Anna At 16:37 2002-08-13 -0700, you wrote: > >I would like to solicit any and all opinions on the following case that we >recently received in consultation. > >75-year-old male with a peripheral blood lymphocytosis (WBC 14.5, atypical >lymphocytes accounting for 95% of the cells), neutropenia, and macrocytic >anemia (Hb 8.3, Hct 25, MCV 109.7). Patient is otherwise asymptomatic. > >Flow cytometry of the peripheral blood showed positivity for CD45 (dim), >CD38 (dim), CD56, HLA-DR, intracytoplasmic CD19 and CD79a with kappa >light-chain immunoglobulin restriction. Cells were negative for all T-cell >markers and surface B-cell markers. Based on the flow findings we thought >this was some type of terminally differentiated B-cell process (loss of >surface B-cell markers, CD56, light-chain restriction, CD38), but the cells >did not have a plasmacytoid or lymphoplasmacytoid appearance. > >Bone marrow had been subsequently obtained and showed sheets of intermediate >to larger lymphoid cells with scant amounts of cytoplasm admixed with >occasional plasma cells. Flow cytometrical analysis showed findings >identical to that of the peripheral blood with the additional finding of >CD13 and CD34 positivity. > >I have found the references where terminally differentiated B-cell processes >can have aberrant myeloid antigen expression, but I have found nothing on >CD34 positivity. > >Does anyone have any experience with a case such as this? > >Thanks! > >Jerry Myers > >JEROME B. MYERS, MD, PhD >COL, MC >Director, Pathology Residency Program >Chief, Clinical Pathology Service >Department of Pathology >Madigan Army Medical Center >Tacoma, WA 98431 >Office (253)968-1723 >Fax (253)968-1084 > > Anna Porwit Hematopathology Lab. Department of Pathology, Radiumhemmet Karolinska Hospital, 171 76 Stockholm, Sweden Anja.Porwit@ks.se tel.:+46-851774518 fax.:+46-851775843
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