case_images: PMC5385891_01
case_images: The characterization of basophils in peripheral blood. (a) Peripheral blood smear showed some medium- to large-sized abnormal cells with lobulated nucleus, and many basophilic granules were observed (May-Giemsa staining, original magnification, x1000). (b) Flow cytometric analysis showed that abnormal cells were positive for CD38, CD123, CD203c, and CD294, which was consistent with basophils. (c) Dual-color FISH analysis using chromosome 7 probes showed that abnormal cell with many granules contained one red signal and one green signal, which indicated monosomy 7 (D7S486 probe, red signal; D7Z1 probe, green signal). Other cells without any granules also showed monosomy 7.
case_images: CRIHEM2017-4695491.001.jpg
case_images: PMC5385891_01_CRIHEM2017-4695491.001.jpg
case_images: fig1
case_images: Some abnormal cells with many basophilic granules appeared in his peripheral blood and then gradually increased in number (Figure 1(a)). Flow cytometric analysis of abnormal cells showed that these cells were positive for CD11b, CD13, CD33, CD38, CD123, CD203c, and CD294 and negative for CD34 and HLA-DR, which was consistent with basophils (Figure 1(b)). The loss of chromosome 7 was found in myeloblasts and basophils of the bone marrow (Figure 1(c)), which showed that basophils were derived from myeloblasts.
case_images: The characterization of myeloblasts in bone marrow. (a) Bone marrow smear showed some large-sized myeloblasts with clear nucleoli, basophilic cytoplasm, and some vacuoles. Some mature basophils were observed (May-Giemsa staining, original magnification, x1000). (b) Flow cytometric analysis showed blasts positive for CD34, CD56, and HLA-DR. (c) Chromosomal analysis by G banding showed 45, XY, -7 /45, idem, add(1)(q21) /46, XY. (d) Dual-color FISH analysis using chromosome 7 probes showed that myeloblasts contained one red signal and one green signal, which indicated monosomy 7 (D7S486 probe, red signal, arrow; D7Z1 probe, green signal, arrow head).
case_images: CRIHEM2017-4695491.002.jpg
case_images: PMC5385891_01_CRIHEM2017-4695491.002.jpg
case_images: fig2
case_images: The bone marrow smear showed 30.4% myeloblasts and 16.8% mature basophils (Figure 2(a)). Flow cytometric analysis showed that the myeloblasts were positive for CD13, CD33, CD34, CD56, CD117, and HLA-DR (Figure 2(b)), which indicated the same phenotype as the blasts in the initial bone marrow examination. Chromosomal analysis by G banding showed monosomy 7 in 14 out of 20 metaphase cells and additional add(1)(q21) in 4 out of 20 metaphase cells analyzed (Figure 2(c)). Monosomy 7 was confirmed by FISH analysis (Figure 2(d)).