title: Adult pre B-cell acute lymphoblastic leukemia with unusually large proportion of bone marrow CD45 bright/high SSc blasts.
abstract: We present a pre B-ALL patient with the rare clinical manifestation of extramedullary disease, and a normal hemogram. This patient's blasts expressed bright CD45 and high side scatter (SSc) placing the cells in the monocyte gate.
  
  
  
  Samples from peripheral blood and bone marrow (BM) aspirate from a 50-year-old female patient were immunophenotyped by multiparametric flow cytometry.
  
  
  
  Flow cytometry studies of the BM aspirate showed a large monocyte gate with 90-95% of the cells expressing an abnormal B cell phenotype. Peripheral white blood cells count was normal and cytogenetic analysis of the BM revealed a normal karyotype.
  
  
  
  It was not possible, based on CD45/SSc to identify a lymphoblast population in this pre B-ALL patient. Although bright expression of CD45 B-ALL blasts has been associated with poor prognosis to the best of our knowledge, the combination of bright CD45 blasts with high SSc has not been reported. As CD45 expression vs. SSc is routinely measured in the diagnostics of acute leukemias, a possible association between CD45 bright positivity and extramedullary disease or prognosis warrants further exploration. © 2015 International Clinical Cytometry Society.
authors.affiliation: Hematology Laboratory, Flow Cytometry Division, Hematology Institute; Tel Aviv University. Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.|Felsenstein Medical Research Center, Sackler School of Medicine, Tel Aviv University. Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Yael
authors.initials: Y
authors.lastname: Shahal-Zimra
authors.affiliation: Hematology Laboratory, Flow Cytometry Division, Hematology Institute; Tel Aviv University. Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Zohar
authors.initials: Z
authors.lastname: Rotem
authors.affiliation: Hematology Laboratory, Flow Cytometry Division, Hematology Institute; Tel Aviv University. Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Judith
authors.initials: J
authors.lastname: Chezar
authors.affiliation: Cytogenetic Institute; Tel Aviv University, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Nino
authors.initials: N
authors.lastname: Oniashvili
authors.affiliation: Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center Petah Tikva and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Avi
authors.initials: A
authors.lastname: Leader
authors.affiliation: Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center Petah Tikva and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Pia
authors.initials: P
authors.lastname: Raanani
authors.affiliation: Hematology Laboratory, Flow Cytometry Division, Hematology Institute; Tel Aviv University. Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.|Cytogenetic Institute; Tel Aviv University, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Esther
authors.initials: E
authors.lastname: Rabizadeh
mesh_terms: D000208:Acute Disease; D001402:B-Lymphocytes / Q000276:immunology*; D001853:Bone Marrow / Q000276:immunology*; D005260:Female; D006801:Humans; D017493:Leukocyte Common Antigens / Q000276:immunology*; D008875:Middle Aged; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology*
chemical_list: D017493:Leukocyte Common Antigens; C516769:PTPRC protein, human
keywords: bright CD45 blasts; high SSc blasts; pre B-ALL