PMC9065302_01
Peripheral blood smear showing blast-like cells exhibiting cytoplasmic pseudopods (100x) (a). Bone marrow aspirate (40x) showing infiltration with atypical cells with eccentric nucleus, fine nuclear chromatin and weakly basophilic, agranular cytoplasm with pseudopods (b). Bone trephine H&E (40x) showing diffuse infiltration with atypical cells and suppression of normal haematopoiesis (c).
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Peripheral blood smear was leucoerythroblastic with presence of 40% atypical cells closely mimicking blast cells (Fig. 1a). Bone marrow smears, and trephine block were requested to be reviewed by our hematopathologist which showed aspicular, hemodiluted specimen exhibiting few atypical cells with eccentric nucleus, fine nuclear chromatin and weakly basophilic, agranular cytoplasm with pseudopods (Fig. 1b). Bone trephine showed diffuse infiltration with suppression of normal haematopoiesis (Fig. 1c).
Screening tube exhibiting negative expression of B, T, myeloid marker and TdT.
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Immunophenotyping of CD45dim positive cells (35%) within blasts gate (performed on BD FACSCanto  II analyzer, 8 color and 3 lasers) revealed positivity to CD33 (29%), HLA-DR.. (35%), CD4 (35%), CD7 (32%) CD123 (35%) and CD56 (35%) but negative for other lineage-specific markers (like CD19, CD79a, CD22, CD10, cytoplasmic and surface CD3, CD5, CD8, MPO,CD13, CD14, CD64, CD36, kappa/lambda light restriction, Tdt,CD34 (Fig. 2& 3).
Extended myeloid panel shows positive CD33 and HLA-DR... pCD specific markers, CD56 and CD123 are positive.
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Immunophenotyping of CD45dim positive cells (35%) within blasts gate (performed on BD FACSCanto  II analyzer, 8 color and 3 lasers) revealed positivity to CD33 (29%), HLA-DR.. (35%), CD4 (35%), CD7 (32%) CD123 (35%) and CD56 (35%) but negative for other lineage-specific markers (like CD19, CD79a, CD22, CD10, cytoplasmic and surface CD3, CD5, CD8, MPO,CD13, CD14, CD64, CD36, kappa/lambda light restriction, Tdt,CD34 (Fig. 2& 3).