acute myeloid leukemias diagnosis in the light of who revisions and correlation with risk adaptive...
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Acute Myeloid Leukemias Diagnosis in The Light of WHO Revisions And Correlation With Risk Adaptive Management; Case Discussions
Dr. Rania Medhat SeliemConsultant Hematopathologist
Head of RH Pathology Laboratory American Board in Clinical and Anatomic Pathology
American Board in Hematology
Clinical History20 Year old male presented withdizziness and easy fatigability. On exam he had hepatomegalyno lymphadenopathy or splenomegalyWBC: 101.9 103/uL, Hb:10.3 g/dL, Plt:34 103/uL
Peripheral Smear
CASE 1
Summary of the FCM FindingsThe blast population was positive for CD34, MPO with partial expression of CD33 and CD13. A very small subpopulation expressed CD19. The noted abnormal myeloid cells were positive for CD33, CD13 and MPO. The cells are negative for CD34, HLA-DR, CD117
CASE 2
Clinical History30 Year old male presented withfever. On exam he had hepatosplenomegalyWBC: 26.1103/uL, Hb:9.6 g/dL, Plt:83 103/uL
Peripheral Smear
Summary of the FCM Findings
Two blast populationsThe first population: The blasts are positive for CD33, CD13 and MPO (myeloid differentiation) The second population The blasts are positive for CD33, CD14, CD64, CD11c, CD11b and MPO (monocytic differentiation)
CASE 3
Clinical History52 Year old female presented withEpigastric pain and body aches fro one week. On exam she had no hepatomegalylymphadenopathy or splenomegalyWBC: 40 103/uL, Hb:12.5 g/dL, Plt:20,000 103/uL
Peripheral Smear
CASE 4Clinical History46 Year old female presented witheasy fatigability. WBC: 6.2 103/uL, Hb:8.8 g/dL, Plt:42 103/uL
Bone Marrow Aspirate
Peripheral Smear
Summary of the FCM Findings
One population of blastsThe blasts are positive for CD33, CD13 (variable expression), CD38 and CD11b
with dim partial expression of MPO. There is partial expression of CD14 and
CD64. Very few cells express CD117 with a subpopulation expressing CD16. The blasts negative for CD34, HLA-DR
and CD7.
Bone Marrow Aspirate & PB
Clinical History17 Year old female presented withRight iliac fossa pain, no organomegaly WBC: 23.9 103/uL, Hb:9.3 g/dL, Plt:67,000 103/uL
CASE 5
Summary of the FCM Findings
One homogenous population of blasts.
The blasts are positive for, CD33, CD64, CD11b, CD4, CD38, and CD56 with partial expression of CD117, CD14 and CD13. The
blasts are negative for CD34, HLA-DR, CD9 and CD16