Expression of NK-associated antigens in extramedullary lymph nodal blast crisis of chronic myeloid leukemia on fine-needle cytology.
A case is reported of a 62-yr-old male suffering from chronic myelogenous leukemia (CML) who developed an extramedullary, para-orthic lymph-nodal blast crisis without blood or bone marrow involvement and expression of CD56/NK associated marker. The diagnosis was performed on ultrasound-guided fine-needle cytology by an immunocytochemical and flow cytometric analysis. Conventional smears showed a monomorphous population of disperse, undifferentiated cells without cytoplasm. Cells showed fragile nuclei, vesicular chromatin, and evident nucleoli. Immunocytochemistry performed on cytospin slides were negative for cytokeratin, LCA, CD20, CD45Ro, and myeloperoxidase (MPO). Flow cytometry analysis proved the myeloid origin of the tumor by expression of CD13, CD34, and CD38 and showed aberrant expression of CD56. Cytological diagnosis was confirmed by histological examination. CD56 expression is generally an expression of NK lymphoid proliferation and may be observed in acute myelogenous leukemia but has rarely been reported in CML and its related blast crisis. This unusual expression, its possible explanation, the related technical problems, and clinicopathological aspects are discussed.
Dipartmento di Anatomia Patologica e Citopatologia, Facoltà di Medicina e Chirurgia, Università di Napoli Federico II, Napoli, Italia.
Pio
P
Zeppa
Gilda
G
Marino
Marco
M
Picardi
Luigia
L
Luciano
Antonio
A
Vetrani
Lucio
L
Palombini
D015703:Antigens, CD / Q000032:analysis; D001707:Biopsy, Needle; D001752:Blast Crisis / Q000473:pathology*; D019002:CD56 Antigen / Q000032:analysis*; D003937:Diagnosis, Differential; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis; D007694:Killer Cells, Natural / Q000473:pathology*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000032:analysis
D015703:Antigens, CD; D019002:CD56 Antigen; D007633:Keratins; D009195:Peroxidase