T-ALL - Slide 1
A presentation consistent with acute leukaemia and hyperleukocytosis (
220⋅109/L
). Although not typical for T-ALL, the most striking feature of these blasts is the rippled and dented nucleus. In addition to blasts, many smudge cells are also visible.
Blasts
Promyelocytes
Metamyelocytes
Neutrophils
Eosinophils
Lymphocytes
Monocytes
Erythroblasts
Smudged
XN Scatterplots
Lymphocytes
Monocytes
Neutrophils & Basophils
Eosinophils
Leukocytes
Basophils
NRBCs
Debris
Erythrocytes
Reticulocytes
RBC fragments
Platelets
immature platelets
Immunophenotype
sCD3-
cCD3+
CD2+
CD5+
CD7+
CD4+
CD8+
TdT+
TCR-
Immunfenotyping shows a large population of young T-cells. These cells do not express surface CD3, but do express cytoplasmatic CD3 (cyCD3+). The T-cel markers CD2, CD5 and CD7 are all positive. The cellular immaturity shows due to absence of HLA-DR and TCR. The blast-marker TdT is positive.
SSC
CD3
CD7
cyCD3
CD1a
CD2
CD5
TdT
CD8
CD4
HLA-DR
CD7
TCRgd
TCRab
Peripheral blood
Bone marrow
Blasts
