FLOW CYTOMETRY:
Results:
Cell suspension immunophenotypic studies were performed on bone marrow aspirate and two regions were analyzed.
Region 1 (R1) represents the small, non-complex cells (7% of the events).
Region 2 (R2) represents the large, non-complex cells (48% of the events).
VIABILITY: 97%
| Antigen | Usual Specificity | % Positive (R1) | % Positive (R2) |
|---|---|---|---|
| Kappa + | B Cell Subset | 52 | 2 |
| Lambda + | B Cell Subset | 2 | 2 |
| Kappa:Lambda Ratio | 26 | 1 | |
| CD19+ | B Cell | 76 | 9 |
| CD19+/CD5+ | B Cell Subset | 69 | 3 |
| CD20+ | B Cell | 45 | 3 |
| CD10+ (Calla) | B Cell Subset | 7 | 6 |
| Antigen | Usual Specificity | % Positive (R1) | % Positive (R2) |
|---|---|---|---|
| CD2+ | T Cell | 18 | 53 |
| CD3+ Total | T Cell | 13 | 2 |
| CD5+/CD19- | T Cell | 16 | 11 |
| CD7+ | T Cell | 16 | 19 |
| CD4+/CD8- | T Helper | 6 | 20 |
| CD8+/CD4- | C Cytotoxic/Suppressor | 8 | |
| CD4+/CD8+ | T Cell Subset | 1 | 1 |
| CD4:CD8 Ratio | T Helper:Suppressor Ratio | 0.75 | |
| CD16,CD56+/CD3+ | T Cell Subset | 1 | |
| CD16,CD56+/CD3- | NK Cells | 3 | 10 |
| Antigen | Usual Specificity | % Positive (R1) | % Positive (R2) |
|---|---|---|---|
| CD13+/CD33+ | Myeloid, monocyte | 25 | 91 |
| CD14+ | Myeloid, monocyte | 2 | 18 |
| CD15+ | Myeloid | 28 | 43 |
| CD34+ | Stem Cell | 5 | 40 |
| CD34+/CD13,33+ | Myeloid, monocyte | 5 | 40 |
| Antigen | Usual Specificity | % Positive (R1) | % Positive (R2) |
|---|---|---|---|
| CD45+ | Leukocytes | 95 | 98 |
| HLA DR+ | B, Myeloid, Activated T | 83 | 95 |
| MPO | Myeloid | 2 | 32 |
Interpretation:
In Region 1, the majority of the cells express CD5 positive/CD19 positive and dim kappa. These findings are consistent with chronic lymphocytic leukemia.
In Region 2, the cells are CD13/CD33 positive, CD2 positive and CD34 positive. These findings are consistent with acute myelogenous leukemia. The expression of CD2 in association with myeloid markers could be used in the follow-up of this patient. The analysis of CD19 combined with CD13 and CD33 indicates that these cells do not express mixed surface markers and two distinct populations are identified by flow cytometric studies.
Final Diagnosis