The bone marrow biopsy (Images 01 and 02) was mildly hypercellular in some areas, with an increased myeloid to erythroid ratio (Image 03). Numerous small lymphocytes (Images 03 and 04) with rounded and occasionally irregular nuclear contours and scant cytoplasm were seen. The aspirate (Images 05 and 06) demonstrated individual tumor cells and tumor cells in clusters.
CD20/L26 (Images 07 and 08), a marker for B-cell lymphocytes demonstrated numerous cellular aggregates and scattered positive cells. CD3 (Image 09), a marker for T-cell lymphocytes demonstrated scattered positive cells in aggregates. The large tumor cells stained positively with S-100 (Image 10), a marker for melanoma.