DZI19-175: Dr. Nardi -Molecular Pathology Slide Sessions

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Set CCSP 2019

Topic Dr. Nardi -Molecular Pathology Slide Sessions

Case	Clinical history	Requester
Case	Clinical history	Requester
Case 1	83 yo woman with leukocytosis (WBC: 50; 75% polys) • mild anemia (HB 11.4; HCT: 36%) and thrombocytopenia (PLT: 109). Peripheral blood and bone marrow biopsy (HE & Giemsa). What is the differential diagnosis?	Sac11
Case 2	55 yo man with history of Ewing sarcoma. Now decreasing WBC and bony lesions. Bone marrow biopsy. The neoplastic cells are CD45– (maybe rare cells staining?) • keratin - • CD34- CD117- MPO- CD56- CD19- CD20- TdT- CD64- CD33- CD13- CD138- lysozyme- FLI-1- CD99+. What is your diagnosis?	Sac11
Case 3	20-month old boy with splenomegaly • thrombocytosis • severe anemia and peripheral blasts WBC: 29.6; HGB: 4.7; HCT: 13.4%; MCV: 85.9 fL; PLT: 900 (Diff: 36% polys; 30% lymphs; 12% monos; 6% eos; 2% basos; 1% myelocytes; 13% blasts; 12 nRBCs/100WBC). Peripheral blood smear. What is your differential diagnosis? Two days later • after RBCs and fluids: WBC: 8.1; HGB: 9.2; HCT: 25.2; MCV: 85 fL; PLT: 250 (Diff: 47% polys; 29% lymphs; 7% monos; 8% blasts; 7% eos; 2% basos; 2% metas Bone marrow biopsy (HE • reticulin stain) and touch prep (clot). What is your differential diagnosis?	Sac11
Case 4	39 yo man with fatigue • chills • back pain & anemia (WBC 4.5; HGB 10.2; HCT 32.2; MCV: 85.4; PLT: 330; Normal differential) Workup included imaging which showed a T9 sclerotic lesion • diffuse bony infiltration • enlarged cervical nodes. Bone marrow biopsy and lymph node biopsy. What are your diagnosis?	Sac11
Case 5	23 yo man with CML in chronic phase now with increasing circulating blastsWBC 50; HGB 11.2; HCT 32.2; MCV: 85.4; PLT: 330 Diff: 42% polys; 11% metas; 3% promyelocytes: 17% basos; 6% eos; 8% blasts; 13% lymphs.Peripheral blood smear • bone marrow biopsy and aspirate smear Is it still CML chronic phase or is it accelerated phase?	Sac11