forms and have open chromatin and occasionally small nucleoli and/or nuclear irregularities. The remaining white blood cells are morphologically unremarkable. The red cell and platelet populations are unremarkable. The bone marrow biopsy is suboptimal due to the small size (0.5 cm). There are large areas of aspiration artifact. In intact areas, the cellularity is approximately 30% with trilineage hematopoietic elements identified. No atypical cellular or lymphoid infiltrate is identified on the routinely stained section. The clot section is adequate with numerous particles present. The cellularity of these particles ranges from 30 to 40%. Megakaryocytes are present with unremarkable morphology. No atypical cellular or lymphoid infiltrate is noted on the routinely stained section. Bone Marrow Referral Report File under: Pathology Pa e 2 of 5
!HE. UN!\'FRSITY 0:;; lfXAS .NID Anderson Gance:f vnter 1515 HOLCOMBE BOULEVARD HOUSTON, TX 77030-4095 Bone Marrow Referral Report Department of Hematopathology, Box 72 Tel: 713-794-1095 Fax 713-794-1800 Collected: Pathologist: MD Received: Case type: Bone Marrow Referral cc: , MD DOB: Age: 57 Physician: , MD Accession: Sex: M Multiple immunohistochemical stains, performed on the clot section, were provided for review. The CD3 stain highlights scattered admixed small T-cells throughout the stroma, which do not appear abnormally increased. The CD20 stain shows a slight increase of B-cells which represent approximately 10% of cellular elements. The B-cells are small and do not form discrete aggregates but are occasionally noted with a sinusoidal-appearing infiltration pattern. Though CD5 coexpression by the B-cells is difficult to assess; the number of CDS-positive lymphocytes is greater than the number of CD3-positive lymphocytes, suggesting CD5 coexpression by the B-cell population. The cyclin 01 stain shows nuclear expression in a subset of lymphocytes as well as endothelial cells. The aspirate smear is of good quality with particles and cells present. The hematopoietic lineages show unremarkable maturation. Lymphocytes are slightly increased and occasionally atypical with somewhat open chromatin, slightly larger than mature size, and with slight nuclear irregularities. Per the provided report, flow cytometric immunophenotyping was performed on this sample ). The results are reported to show a monoclonal kappa-restricted B-cell population reported as positive for CD5, FMC? and kappa light chain and negative for CD10 and CD23. A subset shows CD38 co-expression (approximately one-third of B-cells).
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- Fall '19
- Hematology, Bone marrow, white blood cell