case_images: PMC11812070_01
case_images: Immunophenotyping of the cerebrospinal fluid shows presence of 23% blasts (red), which are CD45 dim with low side scatter area, CD34 dim to negative, CD19 positive, cyCD79a positive, cyCD3 negative, sCD3 negative, CD20 heterogeneous, CD10 (bright), and cynTdT (bright). Lymphocytes are represented by the blue population.
case_images: jyms-2025-42-17f1.jpg
case_images: PMC11812070_01_jyms-2025-42-17f1.jpg
case_images: f1-jyms-2025-42-17
case_images: CNS infiltration due to the underlying malignancy. CSF cytology and immunophenotyping confirmed lymphoblast infiltration (Figs. 1, 2).
case_images: (A, B) Cerebrospinal fluid cytology shows the presence of many background lymphocytes and some blasts (arrows) (May-Grunwald stain, x400).
case_images: jyms-2025-42-17f2.jpg
case_images: PMC11812070_01_jyms-2025-42-17f2.jpg
case_images: f2-jyms-2025-42-17
case_images: CNS infiltration due to the underlying malignancy. CSF cytology and immunophenotyping confirmed lymphoblast infiltration (Figs. 1, 2).
case_images: (A) Bone marrow aspirate and (B) trephine biopsy performed after the central nervous system relapse show heterogeneous population of cells with no increase in blasts (May-Grunwald stain, x400 [A]; hematoxylin-esoin stain, x400 [B]).
case_images: jyms-2025-42-17f3.jpg
case_images: PMC11812070_01_jyms-2025-42-17f3.jpg
case_images: f3-jyms-2025-42-17
case_images: A bone marrow aspiration/trephine biopsy repeated shortly thereafter showed no increase in blasts (Fig. 3), and no new mutations were detected in the BCR::ABL1 kinase domain.