title: CD4+CD56+CD68+hematopoietic tumor of probable plasmacytoid monocyte derivation with weak expression of cytoplasmic CD3.
abstract: Hematopoietic neoplasm coexpressing CD4 and CD56 includes a subset of acute myeloid leukemia with myelomonocytic differentiation, plasmacytoid monocyte tumor, and other immature hematopoietic neoplasms of undefined origin. Herein, we report a CD4+CD56+CD68+ hematopoietic tumor that was thought to be a tumor of plasmacytoid monocytes. This case is unique in the absence of accompanying myelomonocytic leukemia and the faint expression of cCD3 on the tumor cells. The patient was a 22-yr old man presented with multiple lymphadenopathy and an involvement of the bone marrow. Tumor cells were large and monomorphic with an angulated eosinophilic cytoplasm of moderate amount. Nuclei of most tumor cells were eccentric and round with one or two prominent nucleoli. Rough endoplasmic reticulum was prominent in electron microscopic examination. Tumor cells expressed CD4, CD7, CD10, CD45RB, CD56, CD68, and HLA-DR and were negative for CD1a, CD2, sCD3, CD5, CD13, CD14, CD20, CD33, CD34, CD43, CD45RA, TIA-1, S-100, and TdT. cCD3 was not detected in the immunostaining using paraffin tissue, but was faintly expressed in flow cytometry and immunostaining using a touch imprint slide. T-cell receptor gene rearrangement analysis and EBV in situ hybridization showed negative results. Cytochemically, myeloperoxidase, Sudan black B, and alpha naphthyl butyrate esterase were all negative.
authors.affiliation: Department of Diagnostic Pathology, Clinical Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yhko@smc.samsung.co.kr
authors.forename: Young Hyeh
authors.initials: YH
authors.lastname: Ko
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Kim
authors.forename: Keunchil
authors.initials: K
authors.lastname: Park
authors.forename: Howe Jung
authors.initials: HJ
authors.lastname: Ree
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000096:biosynthesis*; D015214:Antigens, Differentiation, Myelomonocytic / Q000096:biosynthesis*; D001854:Bone Marrow Cells / Q000473:pathology; D017252:CD3 Complex / Q000096:biosynthesis*; D015704:CD4 Antigens / Q000096:biosynthesis*; D019002:CD56 Antigen / Q000096:biosynthesis*; D002467:Cell Nucleus / Q000473:pathology; D004804:Eosinophils / Q000378:metabolism; D005434:Flow Cytometry; D015321:Gene Rearrangement; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis / Q000378:metabolism*; D017493:Leukocyte Common Antigens / Q000096:biosynthesis; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008854:Microscopy, Electron; D009000:Monocytes / Q000378:metabolism*; D011948:Receptors, Antigen, T-Cell / Q000378:metabolism; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D017252:CD3 Complex; D015704:CD4 Antigens; D019002:CD56 Antigen; D017493:Leukocyte Common Antigens; D011948:Receptors, Antigen, T-Cell; C067980:CD68 antigen, human; D000097382:CD68 Molecule