AML - Slide 6
An unusual case of acute myeloid leukemia in which, morphologically, multiple blasts populations appear to exist; Large, irregularly shaped blasts (type 1). Medium-sized blasts with nicked and cleft nuclei (type 2). Small elongated blasts (type 3) and small round blasts (type 4). However, immunophenotyping does not satisfy the criteria for mixed-phenotype acute leukemia (MPAL, see immunophenotype)
XN Scatterplots
Lymphocytes
Monocytes
Neutrophils & Basophils
Eosinophils
Leukocytes
Basophils
NRBCs
Debris
Erythrocytes
Reticulocytes
RBC fragments
Platelets
immature platelets
Immunophenotype
CD34+
CD117+
MPO+
HLA-DR+++
CD19±
cyCD79a+
CD13+
CD33+
The blast population (CD34+) was found to have both myeloid (MPO+, CD117+) and lymphoid markers (CD19 weak, CD79a+). However, according to WHO criteria, lymphocytic cells with weak CD19 expression must also express at least two other lymphoid markers (CD79a, CD22 or CD10) before they can be assigned to the lymphocytic lineage. However, other myeloid markers were strongly positive (CD13, CD33). Consequently, it was concluded that these were myeloid blasts with aberrant expression of CD19 and CD79a.
SSC
CD45
CD34
HLA-DR
CD117
CD34
CD13+CD33
MPO
CD13+CD33
TdT
CD15
CD10
cyCD22
CD19
cyCD79a
cyCD3
Peripheral blood
Bone marrow
Blasts
Blasts
Blasts
Blasts
