PMC7423397_01
(A) Morphology of leukemic cells at diagnosis (original magnification, x1000) for case 1. (B) Flow cytometry result for case 1. (C) Morphology of leukemic cells at diagnosis (original magnification, x1000) for case 2. (D) Flow cytometry result for case 2. (E) Karyotype analysis showed normal result of case 1. (F) Dual-color FISH analysis of case 1 with LSI BCR-ABL1 dual-color, dual-fusion translocation probe showing a monoallelic loss of the ABL gene. The ABL gene (9q34) was labeled as orange, and the BCR gene (22q11.2) was labeled as green.
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The proportion of blasts in bone marrow was 81.2% (Figure 1C), and flow cytometry (Figure 1D) showed the blasts (P3 group, 80.2%) mainly expressed CD7, CD33 and CD34; partially expressed CD11b, HLA-DR, CD123, CD64 and CD13; and did not express CD10, CD117, CD16, CD19, CD10, MPO, cCD3, cCD79a, CD14, CD3, CD15, CD4, CD8, CD2, CD25, CD9 and CD11c, which indicated AML.
PMC7423397_02
(A) Morphology of leukemic cells at diagnosis (original magnification, x1000) for case 1. (B) Flow cytometry result for case 1. (C) Morphology of leukemic cells at diagnosis (original magnification, x1000) for case 2. (D) Flow cytometry result for case 2. (E) Karyotype analysis showed normal result of case 1. (F) Dual-color FISH analysis of case 1 with LSI BCR-ABL1 dual-color, dual-fusion translocation probe showing a monoallelic loss of the ABL gene. The ABL gene (9q34) was labeled as orange, and the BCR gene (22q11.2) was labeled as green.
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The proportion of blasts in bone marrow was 81.2% (Figure 1C), and flow cytometry (Figure 1D) showed the blasts (P3 group, 80.2%) mainly expressed CD7, CD33 and CD34; partially expressed CD11b, HLA-DR, CD123, CD64 and CD13; and did not express CD10, CD117, CD16, CD19, CD10, MPO, cCD3, cCD79a, CD14, CD3, CD15, CD4, CD8, CD2, CD25, CD9 and CD11c, which indicated AML.
PMC7423397_03
(A) The result of Lung CT+ enhancement for case 3.The tumor is marked by arrow. (B) The result of PET-CT for case 3. The tumor is marked by arrow. (C) Immunohistochemical staining of the mediastinal mass biopsy for case 3. (D) Schematic representation of SET, CAN, and SET-CAN proteins. Fusion breakpoints are indicated with vertical arrowhead.
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The result of Lung CT+ enhancement showed left hilar and mediastinal space occupying lesions, 5.6 x 4.0 cm in diameter, with left upper lobe obstructive changes, pericardial effusion and left pleural effusion (Figure 2A). The left pleura was thickened with increased metabolism, and the metabolism of the left neck and upper and lower clavicle lymph nodes was also increased (Figure 2B). Immunohistochemical staining of the mediastinal mass biopsy (Figure 2C) displayed diffused abnormal proliferative cells with CD7(+)Pax8(+) CD33(+)CD43(+)CD99(+) CD4(+) LMO-2(+) Ki67(85%), while a few scattered cells were positive for CD117, Pax5 and CD8.