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Acute leukemia with mediastinal mass, lymphadenopathy, and monocytic precursor cells
Author(s) -
Schwarzmeier Josef D.,
Bettelheim Peter,
Radaszkiewicz Thaddäus,
Prischl Friedrich,
Schwabe Michael,
Fuhrmann Manfred
Publication year - 1986
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830220312
Subject(s) - medicine , mediastinal mass , mediastinal lymphadenopathy , leukemia , monocytic leukemia , pathology , cancer research , immunology , biopsy
Cell marker analysis with monoclonal antibodies (MoAb) as well as differentiation studies with the chemical inducer TPA were used to identify a population of apparently lymphoid cells as monocytic precursor cells in a patient with acute leukemia. The initial manifestation of the disease with mediastinal mass and lymphadenopathy was followed by the appearance of small lymphocyte‐like blast cells in bone marrow (BM) and peripheral blood (PB). Although a lymph node biopsy revealed an infiltration with monoblasts, the leukemic cells in BM and PB were not classifiable. However, when the patient relapsed after chemotherapy with large monoblasts and again with morphologically lymphoid blast cells, the latter could be classified by treatment with TPA. After incubation with the inducer (12–48 hr) the cells became positive with the MoAB VIM‐D5, showed a strong reaction with α‐napthyl‐acetate‐esterase and developed macrophage like morphology, as well as phagocytic properties. During the terminal phase of the disease, small, lymphocyte‐like blast cells predominated. These cells could be classified by a panel of MoABs. They expressed myeloid determinants (VIM‐D5, VIM‐2, MY 9, VIM‐12, VIM‐13) but showed no reactivity with MoABs specific for lymphocytic cells.