PMC9168658_01
Wright-Giemsa stain of bone marrow (x1,000). (A) Hemophagocytosis in bone marrow smear. (B-D) Large granular variant lymphocytes in bone marrow smear and the proportion was 6%.
fped-10-829927-g001.jpg
PMC9168658_01_fped-10-829927-g001.jpg
F1
Hemophagocytosis and large granular variant lymphocytes were scattered seen in bone marrow smear, and the proportion of large granular variant lymphocytes was 6% (Figure 1).
The flow cytometry detection of bone marrow revealed CD3-CD56+ cells counted for 55.67% of the lymphocytes, with HLA-DR+, CD2+, CD7 (dim)+, CD16+, CD38+, CD56+, and CD3-.
fped-10-829927-g002.jpg
PMC9168658_01_fped-10-829927-g002.jpg
F2
CD3-CD56+ cells counted for 55.67% of the lymphocytes, with HLA-DR+, CD2+, CD7 (dim)+, CD16+, CD38+, CD56+, and CD3- (Figure 2). Chromosome karyotype analysis found 46, XX, t (6;9) (q23; p24).
Axial magnetic resonance imaging of the brain in this ANKL patient. Axial T2-weighted (1B-3B) and fluid-attenuated inversion recovery (1C-3C) of brain showing white matter high signal at bilateral centrum ovale, periventricular areas, basal ganglia areas and pontine. Axial T1-weighted (2A) imaging and diffusion-weighted imaging (2D) shows high signal at areas of putamen and caudate nucleus head.
fped-10-829927-g003.jpg
PMC9168658_01_fped-10-829927-g003.jpg
F3
Axial T1-weighted imaging and diffusion-weighted imaging showed high signal at areas of putamen and caudate nucleus head (Figure 3).
Typical laboratory indexes of blood and the drugs used for the patient from day of admitting, she died 55 days later. LDH, lactic dehydrogenase; ALY, atypical lymphocyte; WBC, white blood cell; DDI, D-Dimer; DEX, dexamethasone; MP, methylprednisolone; VP16, etoposide; DOX-lip, doxorubicin liposomes; L-Asp, L-asparaginase; BTZ, bortezomib.
fped-10-829927-g004.jpg
PMC9168658_01_fped-10-829927-g004.jpg
F4
Ultimately this patient deceased due to lethal hemorrhagic complications: pneumorrhagia and gastrointestinal bleeding (Figure 4).