case_images: PMC8219029_01
case_images: Cellular morphology of bone marrow aspirate smear and chromosome karyotypes. (A, B) Bone marrow smear showing a proliferation of blasts (Giemsa-Wright stain). (A, B) The blasts exhibited medium sizes, round, round-like or irregularly shape, the cytoplasm were less with trailing and burr-like changes (100 x oil immersion). (C) The cytochemiscal staining was negative for POX (peroxidase). (D) Chromosome analysis demonstrated + 4 (arrow) in 4 of 10 metaphases examined.
case_images: OTT-14-3795-g0001.jpg
case_images: PMC8219029_01_OTT-14-3795-g0001.jpg
case_images: f0001
case_images: Cytochemistry revealed these blasts were negative for POX (peroxidase) staining (Figure 1).
case_images: Immunophenotypic analysis of the blasts cells exhibited ETP-ALL. Through the flow cytometry analysis, blast cells were gated and showed in blue (P3). Normal mature lymphocytes were showed in green for comparison (P2). The immunophenotype of blasts were CD7, CD117, CD34, CD33, CD38, CD3 (dim), cytoplasmic CD3, and negative for TDT, CD123, CD36, HLA-DR, CD64, CD11b, CD13, CD16, CD14, CD15, CD64, CD11c, CD4, CD5, CD8, CD10, CD19, lambda, kappa, CD20, CD22, MPO, CD1a, CD99, CD2. The phenotype was consistent with early T-cell precursor acute lymphoblastic leukemia (ETP-ALL).
case_images: OTT-14-3795-g0002.jpg
case_images: PMC8219029_01_OTT-14-3795-g0002.jpg
case_images: f0002
case_images: TDT, CD123, CD36, HLA-DR, CD64, CD11b, CD13, CD16, CD14, CD15, CD64, CD11c, CD4, CD5, CD8, CD10, CD19, lambda, kappa, CD20, CD22, MPO, CD1a, CD99, CD2 (Figure 2).