2011-06-16
Mystery cells, case #1
Please tell us the diagnosis and the strange cells that are present!
This post comes from our colleague Scott Dunbar, located in the state of California. He collects interesting cell images and sometimes he has unknown cases which he tries to find out the diagnosis. Going forward as his image library grows and he gets more patient case studies, he will provide more interesting cases and differential diagnosis at the CellaVision News Blast.
So here are the patient details:
54 year old female
WBC 14.2
RBC 2.79
HGB 8.6
PLT 122
Numerous NRBC’s. (80 counted)
The cells were collected this past spring and ran on a CellaVision DM96 at an anonymous Hospital.
The purpose of this post is educational and used to encourage better morphologists. Please share your suggested diagnosis and cell types with your peers at this blog! The diagnosis will be exposed next Wednesday.
Click to enlarge the cells.
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Cells – 1 A, B, C, D, 2A Blasts(myeloblast)
Cells – 2, B, C, D, 3A, B, C, D, Erythrblasts with dysplastic changes
Cells – 4A, B, C, D, 5A, B, C, D 6A, B, C, D Basophilic Blasts
Blast cells, dysplastic erythroblasts, micromegakaryocytes
abnormal platelets. MDS or ET in transformation
Blasts and micromegakaryocytes in addition to the NRBCs. The micromegs look dysplastic as do the NRBCs.
Cell types 1A-2A Myelobasts
2B-3D Erythroblasts “dysplastic”
4A-6D Bare Megakrocytes nucleus. “micro”
Also note the atypical greyish colored thrombocytes. Suggestion. MDS transformation to Acut myeloid leukemia.
I guess large cell transformation of follicular lymphoma together with chemotherapy induced MDS.