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Final Interpretation of Case #1

The cell representations are listed below.

B cells

CD19= 7%
CD20= 7%
CD10= 0%
HLA-DR= 10%
CD19/CD5 dual + = 0%
Kappa=4%
Lambda=3%

Interpretation of the above data (refer to the decision tree to assist with interpretation of the case):

  • There is a good mix of kappa and lambda; neither one is predominant.
  • The B cells do not express CD5 (a B cell that expresses CD5 is abnormal because CD5 is normally a T cell marker)
  • CD10 is not present on the B cells.
  • Conclusion: B cells are NORMAL

T cells

CD2= 91%
CD5= 90%
CD7= 91%
CD3= 88%

  • The pan T cell markers all are within a few percentage points of one another, which translates to the sample having all markers that should be there and no values are skewed toward one marker.
  • CD4 plus CD8 equals the total CD3 (55 + 33 = 88), therefore, there is good representation of both T helper and cytotoxic T cells (a neoplastic process could have predominantly one or the other or dual positive CD4 and CD8).
  • Conclude: T cells are NORMAL


Final conclusion: this is a normal peripheral blood lymphocyte population and there is no indication of a neoplastic process. The B cells that are present, though a small percentage of the total lymphocytes, have no abnormal markers. Most of the lymphocytes in this sample are T cells, yet they are normal as well. The CD markers that should be there are present and there is a good representation of both helper and cytotoxic cells.