case_images: PMC6335663_01
case_images: (a). Flow cytometric analysis of peripheral blood at diagnosis.   means leukemic cell gate. Leukemic cells are positive in IgGlambda, CD20, CD19, CD23, CD5, and HLA-DR. (b) Hematoxylin and eosin staining of leukemic cells in the bone marrow clot (x 400). (c) Immunostaining of CD20 (x 400).
case_images: CRIHEM2019-9710790.001.jpg
case_images: PMC6335663_01_CRIHEM2019-9710790.001.jpg
case_images: fig1
case_images: IgGlambda (Figure 1(a)). IgH/cyclinD1 translocation was negative in fluorescence in situ hybridization analysis.
case_images: Clinical course. Absolute number or white blood cells (WBC,  ), lymphocytes ( ), and soluble IL2-receptor (sIL-2R,  ) were shown in graph. R-CHOP, rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone; Flu, fludarabine; TBI, total body irradiation; uBMT, unrelated bone marrow transplantation; sMTX, short-term methotrexate; CDR III, complementarity determining region III.
case_images: CRIHEM2019-9710790.002.jpg
case_images: PMC6335663_01_CRIHEM2019-9710790.002.jpg
case_images: fig2
case_images: Soluble interleukin-2 receptor was also markedly elevated (10,400 U/ml; normal, 190-650 U/ml; Table 1 and Figure 2). Tacrolimus and short-term methotrexate were used for graft-versus-host disease (GVHD) prophylaxis (Figure 2).