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Acute Myeloid Leukemias Diagnosis in The Light of WHO Revisions And Correlation With Risk Adaptive Management; Case Discussions

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Acute Myeloid Leukemias Diagnosis in The Light of WHO Revisions And Correlation With Risk Adaptive Management; Case Discussions Dr. Rania Medhat Seliem – PowerPoint PPT presentation

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Title: Acute Myeloid Leukemias Diagnosis in The Light of WHO Revisions And Correlation With Risk Adaptive Management; Case Discussions


1
Acute Myeloid Leukemias Diagnosis in The Light of
WHO Revisions And Correlation With Risk Adaptive
Management Case Discussions
  • Dr. Rania Medhat Seliem
  • Consultant Hematopathologist
  • Head of RH Pathology Laboratory
  • American Board in Clinical and Anatomic Pathology
  • American Board in Hematology

2
Peripheral Smear
CASE 1
Clinical History 20 Year old male presented
with dizziness and easy fatigability. On exam he
had hepatomegaly no lymphadenopathy or
splenomegaly WBC 101.9 103/uL, Hb10.3 g/dL,
Plt34 103/uL
3
Bone Marrow Aspirate
4
Flow Cytometry
5
Summary of the FCM Findings
  • The blast population was positive for CD34, MPO
    with partial expression of CD33 and CD13. A very
    small subpopulation expressed CD19.
  • The noted abnormal myeloid cells were positive
    for CD33, CD13 and MPO. The cells are negative
    for CD34, HLA-DR, CD117

6
Peripheral Smear
CASE 2
Clinical History 30 Year old male presented
with fever. On exam he had hepatosplenomegaly WBC
26.1103/uL, Hb9.6 g/dL, Plt83 103/uL
7
Bone Marrow Aspirate
8
Flow Cytometry
9
Summary of the FCM Findings
  • Two blast populations
  • The first population The blasts are positive for
    CD33, CD13 and MPO (myeloid differentiation)
  • The second population The blasts are positive
    for CD33, CD14, CD64, CD11c, CD11b and MPO
    (monocytic differentiation)

10
CASE 3
Clinical History 52 Year old female presented
with Epigastric pain and body aches fro one week.
On exam she had no hepatomegaly lymphadenopathy
or splenomegaly WBC 40 103/uL, Hb12.5 g/dL,
Plt20,000 103/uL
11
Bone Marrow Aspirate
12
Flow Cytometry
13
Clinical History 46 Year old female presented
with easy fatigability. WBC 6.2 103/uL, Hb8.8
g/dL, Plt42 103/uL
CASE 4
Bone Marrow Aspirate
Peripheral Smear
Peripheral Smear
14
Flow Cytometry
15
Summary of the FCM Findings
  • One population of blasts
  • The blasts are positive for CD33, CD13 (variable
    expression), CD38 and CD11b with dim partial
    expression of MPO. There is partial expression of
    CD14 and CD64. Very few cells express CD117 with
    a subpopulation expressing CD16. The blasts
    negative for CD34, HLA-DR and CD7.

16
Clinical History 17 Year old female presented
with Right iliac fossa pain, no organomegaly WBC
23.9 103/uL, Hb9.3 g/dL, Plt67,000 103/uL
CASE 5
Bone Marrow Aspirate PB
17
Flow Cytometry
18
Summary of the FCM Findings
  • One homogenous population of blasts.
  • The blasts are positive for, CD33, CD64, CD11b,
    CD4, CD38, and CD56 with partial expression of
    CD117, CD14 and CD13. The blasts are negative for
    CD34, HLA-DR, CD9 and CD16

19
Thank You!
  • See You At the Lecture!
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