case_images: PMC6199862_01
case_images: (a) Computed tomography (CT) at the time of multiple myeloma (MM) diagnosis. Sacral tumor and lytic bone involvement in the lumbar spine are shown (arrow). (b) Serum immunofixation at the time of MM diagnosis. SP, size marker; G IgG; A IgA; M IgM; kappa, kappa chain; lambda, lambda chain.
case_images: CRIHEM2018-7863943.001.jpg
case_images: PMC6199862_01_CRIHEM2018-7863943.001.jpg
case_images: fig1
case_images: Lumbar magnetic resonance imaging and computed tomography (CT) suggested the presence of lumbar spinal canal stenosis and a sacral tumor (Figure 1(a)). M-protein, with an estimated serum-free kappa and lambda chain ratio of 21.5 : 1 (Figure 1(b)). Microscopic examination and flow cytometric analysis of bone marrow aspirate revealed elevated numbers of
case_images: (a) Karyotype from a bone marrow specimen at the time of chronic myeloid leukemia (CML) diagnosis. t(9; 22) is shown by using arrows. (b) Fluorescence in situ hybridization for peripheral blood cells. Arrowheads, BCR-ABL fusion gene (yellow); large arrows, ABL signal (red); small arrows, BCR signal (green). (c) Polymerase chain reaction (PCR) amplification analysis from the bone marrow specimen taken at the time of CML diagnosis. Lane 1, size marker; lane 2, p210 negative control; lane 3, p190 negative control; lane 4, p210 positive control; lane 5, p190 positive control; lane 6, p210 patient's sample; lane 7, p190 patient's sample.
case_images: CRIHEM2018-7863943.002.jpg
case_images: PMC6199862_01_CRIHEM2018-7863943.002.jpg
case_images: fig2
case_images: Peripheral blood neutrophils were also positive for BCR-ABL (98.8%) (Figures 2-2). Chimeric p190, but not p210, BCR-ABL mRNA was detected by using polymerase chain reaction (Figure 2).