Ann Lab Med.  2017 Sep;37(5):443-445. 10.3343/alm.2017.37.5.443.

Hidden “Preleukemic Phase” of Chronic Myeloid Leukemia Presenting Without Leukocytosis in the Peripheral Blood Unrelated to Chemotherapy in a Patient Diagnosed With Diffuse Large B Cell Lymphoma

• Yoo DW
• Park SH
• Yi J
• Kim IS
• Kim HH
• Chang CL
• Lee EY

• KMID: 2383922
• DOI: http://doi.org/10.3343/alm.2017.37.5.443

Abstract

No abstract available.

MeSH Terms

Drug Therapy*
Humans
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*
Leukocytosis*
Lymphoma, B-Cell*

Figure

• 

  Fig. 1 Peripheral blood smear, bone marrow aspiration, touch print, biopsy, and immunohistochemical staining results of the patient at initial diagnosis. (A) Peripheral blood smear results of the patient demonstrating the absence of leukocytosis, atypical lymphocytes or immature granulocytes (400×, Wright stain). (B, C) Bone marrow aspiration smear and touch print indicating slightly hypercellular marrow with mild granulocytic and megakaryocytic hyperplasia without atypical lymphocytes (B, 200×; C, 400×; Wright stain). (D) Bone marrow biopsy section demonstrating approximately 60% cellularity with mild granulocytic hyperplasia, eosinophilia, and megakaryocytic hyperplasia without evidence of neoplastic lymphoid cell infiltration (40×, hematoxylin & eosin stain). (E, F) Immunohistochemical stain results of CD45RO (200×) and CD20 (200×) demonstrating the infiltration of a few reactive T and B lymphocytes, respectively.

• 

  Fig. 2 Karyotype analysis results of the patient after initial evaluation of the peripheral blood smear and bone marrow examinations. Karyotype analysis results indicate the presence of the t(9;22)(q34;q11.2) in 19 of 20 cells evaluated.

Reference

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3. Aye le L, Loghavi S, Young KH, Siddiqi I, Yin CC, Routbort MJ, et al. Preleukemic phase of chronic myelogenous leukemia: morphologic and immunohistochemical characterization of 7 cases. Ann Diagn Pathol. 2016; 21:53–58.