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ISSN: 1233-9687
Polish Journal of Pathology
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vol. 71
Original paper

Quiz. What is your diagnosis?

Stefano Licci

Department of Pathology, “San Filippo Neri” Hospital, Rome, Italy
Pol J Pathol 2020; 71 (2): 194-194
Online publish date: 2020/07/22
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An 86 years old man underwent a bone marrow biopsy for thrombocytopenia and monoclonal gammopathy. Morphological examination showed a hypercellular marrow for the age of the patient (> 90%). A routinary first step immunohistochemical study better disclosed the presence of nodular aggregates of PAX5+ (Fig. 1A, 2,5×) B lymphoid cells in the context of bone marrow tissue. The aggregates were composed of small and mature lymphocytes (Fig. 1B, hematoxylin-eosin, 20×, arrows) with a prevalent B immunophenotype, as highlighted by CD20 immunostain (Fig. 1C, 20×). Nodules were surrounded by haematopoietic tissue represented predominantly (about 70% of marrow cellularity) by immature elements (Fig. 1B hematoxylin-eosin, 20×), with a positive immunostain for myeloperoxidase (MPO) (Fig. 1D, 20×) and CD34. Further immunophenotyping showed coexpression in B cells of CD5, CD23 and CD43 (cyclin D1, SOX11, CD10 and bcl6 were negative), in presence of admixed small T cells (CD3+, CD5+, CD43+). Immature haematopoietic cells, in addition to MPO and CD34, tested positive for CD117 (c-kit) (glicophorin-C, CD61, CD7, CD15 and Tdt were negative).
Copyright: © 2020 Polish Association of Pathologists and the Polish Branch of the International Academy of Pathology This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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