1. In a normal 50 y/o adult, what is the expected bone marrow cellularity?

2. When examining a bone marrow core (trephine) biopsy, where should immature myeloid elements be localized?

3. The blood smear shown in this case comes from a 62-year-old male with a white count of 55,000. Based on the findings, what is the most likely flow cytometry immunophenotype?

4. The images for this case come from a 56-year-old Hispanic male who presents an otolaryngologist with a nasal mass. A surgical biopsy was performed, and representative images including immunohistochemical stains are shown. Based on the morphology and special stains, what is the best diagnosis?

5. Image for this case shows FISH study (R - 15q22, G - 17q21). Based on the image and associated information, what is the best diagnosis?

 

6. The bone marrow biopsy in this case comes from a 63-year-old male is found to have a monoclonal IgM serum paraprotein. The patient had symptoms of hyperviscosity and received a plasma exchange. Flow cytometry the bone marrow aspirate showed positivity for CD19, CD20, CD22, CD79a, and CD38. The cells of interest were for negative for CD5, CD10, and CD23. Additional immunohistochemistry stains are shown in the images for this case. Conventional cytogenetics showed a translocation t(9;14)(p13;q32). Based on these findings was the most likely diagnosis?

7. A 29-year-old African-American patient is found to have a peripheral eosinophilic count of 8000/microliter. The peripheral blood and bone marrow are shown for review. Conventional cytogenetics are normal, and appropriate FISH studies are normal. Flow cytometry was performed, and showed no monoclonal B-cell or aberrant T-cell population. Extensive allergy and infectious disease workup was negative.

What is the most important follow-up test?

8. The images of peripheral blood and a bone marrow biopsy come from a 25-year-old African American female who presents with a WBC of 65, 000, which is composed of 90% neutrophils. The patient complains of B symptoms, but after extensive work of no infectious theology is found. Appropriate cytogenetic, FISH, and PCR studies were performed with no abnormalities. A bone marrow biopsy was performed and revealed no evidence of abnormal maturation in any of the hematopoietic lineages. The patient has a normal hemoglobin, in the monocytes are <1x10^9. Based on these findings, was most likely diagnosis?

9. Which of the following are individually specific markers used in flow cytometry analysis?

10. A 29-year-old African-American patient is found to have a peripheral eosinophilic count of 8000/microliter. The peripheral blood and bone marrow are shown for review. Conventional cytogenetics are normal, and appropriate FISH studies are normal. Flow cytometry was performed, and showed no monoclonal B-cell or aberrant T-cell population. Extensive allergy and infectious disease workup was negative. Based on these findings, what is the best diagnosis?