| Session: Therapy-related myeloid neoplasm |
| Case number: 206 |
Submitter(s): Falko Fend, Helge Menzel.
Clinical history
This 53-year old male was treated for a mediastinal T-lymphoblastic lymphoma diagnosed in a mediastinal trucut biopsy (CD3+, CD4+, CD7+, CD5-, CD8-, TdT+, CD99+). The bone marrow at this time was negative for involvement by the T-LBL. 44 months later, the patient developed pancytopenia. A diagnosis of myelodysplastic syndrome with transformation into AML with erythroblastic differentiation was made. The patient received treatment, but did not achieve remission The present biopsy was taken six months after primary diagnosis and 4 years after diagnosis of T-LBL. Briefly afterwards, the patient died of infectious complications before an allogeneic BM transplant could be performed.
Details of gross/microscopic pathology:
Bone marrow trephine biopsy fixed in formalin and decalcified in EDTA.
Immunophenotype (flow cytometry/immunohistochemistry):
The complete immunphenotype and flow cytometry data will be presented.
Immunohistochemistry: CD34-/+; Glycophorin C+.
Cytogenetics:
highly complex karyotype 71-74XY.
Molecular analysis:
Not performed.
Interesting feature(s) of submitted case:
This unusual case of alkylating agent therapy-related AML with erythroblastic differentiation shows the spectrum of therapy-related myeloid disorders. Differentiation of pure erythroid leukemia from MDS with trilinear dysplasia is difficult.
Proposed diagnosis:
Secondary (therapy-related) AML, pure erythroid differentiation.
Panel diagnosis:
agree with proposed diagnosis
Comments:
Stain performed by the panel: CD61 negative
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