case_images: PMC10846498_01
case_images: Cytogram in ADVIA 2120: Baso channel (a) and Perox channel (b). An increase in cell count is observed in the Baso channel within the blast region (highlighted in white). The Perox channel reveals an elevation of cells identified as large unstained cells (highlighted in cyan).
case_images: jmc-15-031-g001.jpg
case_images: PMC10846498_01_jmc-15-031-g001.jpg
case_images: F1
case_images: The cytogram generated by the automated count was analyzed, revealing an 8.6% population of cells with loosely dispersed chromatin in the Baso channel window (Fig. 1a), suggestive of blasts. The Perox channel window exhibited a 15.6% population of LUC (Fig. 1b).
case_images: (a) Histogram of nucleated red blood cells in ADVIA 2021. A third peak is observed in orange (indicated by a white arrow), identifying non-stained cells with myeloperoxidase, which runs parallel to the lymphocyte peak in blue. (b) Plasma cell in peripheral blood film.
case_images: jmc-15-031-g002.jpg
case_images: PMC10846498_01_jmc-15-031-g002.jpg
case_images: F2
case_images: Additionally, the histogram of nucleated red blood cells showed a peak of unstained events in parallel with lymphocytes (Fig. 2a). With this suspicion in mind, peripheral blood smears were meticulously examined, confirming an 8% population of circulating plasma cells out of a total of 200 analyzed nucleated cells (Fig. 2b), thereby confirming the diagnosis of secondary plasma cell leukemia.