PMC4102379_01
(A-E) - Histopathological features and flow cytometry dot plots of bone marrow (BM) biopsy and aspirate. A-B) Hameatoxylin and eosin (H&E) staining of bone marrow showing interstitial and nodular infiltration by small and mature lymphocytes - (60 and 500x magnification) C-E) Dot plots from the bone marrow aspirate originating from CD5 and CD19 positive lymphocyte population (not shown) showing bright CD20, FMC-7 and dim to negative CD23 expression suggestive of atypical CLL.
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F1
A repeat BM biopsy showed - cellularity 20%, increased small lymphocytes with an interstitial and nodular distribution (Figure 1 A-B; H&E 60x and 500x magnification), and 50% of cellularity with few dysplastic megakaryocytes and mild erythroid hypoplasia. BM aspirate demonstrated a discrete population of lambda light chain restricted aberrant B-cells, positive for CD19, CD5, CD20 bright, CD200, FMC-7 and dim CD23 expression (Figure 1 C-E; flow cytometry dot plots of CD20, FMC-7 and CD23). BM cytogenetics showed normal female karyotype (18 metaphases), +8 in one and 5q- in one metaphase.