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| Case Study Interpretation (CSI) |
Clinical History:
61 year old man with no significant past medical history presented to his primary care physician complaining of fatigue, easy bruising, mild dyspnea on exertion, and headache for 3 weeks.
| CBC |
Normal Range |
| WBC: 24.0 x 109/l |
(4.8 – 10.8)
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| RBC: 3.51 x 1012/l |
(4.7 – 6.1)
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| Hgb: 11.2 g/dl |
(14.0 – 18.0)
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| Hct: 31.5 % |
(42.0 – 52.0) |
| MCV: 89.8 fl |
(80.0 – 94.0) |
| MCH: 32.0 pg |
(27.0 – 31.0) |
| MCHC: 35.6 g/dl |
(33.0 – 37.0) |
| RDW: 15.4% |
(11.5 – 14.5) |
| Plts: 19.0 x 109/l |
(160 – 360) |
| CBC Differential |
Percent |
| Granulocytes |
11% |
| Bands |
1% |
| Lymphocytes |
6% |
| Monocytes |
1% |
| Basophils |
2% |
| Eosinophils |
0% |
| Blasts/Promyelocytes |
72 |
Bone marrow aspirate and biopsy were received for evaluation.
Flow cytometric immunophenotyping was performed on a portion of the bone marrow aspirate and the results from selected 3-color and 5-color tubes are provided for review.
Flow Cytometric Files:
Acquired with a FC500 and initially analyzed with CXP Analysis 2.0 and then with FSC Express version 3
Tube 1: CD34~FITC/ CD2~PE/ CD117~PC5/ CD45~PC7
Tube 2: CD7~FITC/ CD33~PE/ CD45~PC7
Tube 3: HLA-DR~FITC/ CD13~PE/ CD45~PC7
The listmode files are available in 2 ways. The files labeled CASE are FCS 2.0 files readable with software including CXP, FCS Express, and WinList. The files labeled CASEv2 are compensated and scaled versions of the original files readable using software including Flow Jo.
Download FCS 2.0 files (ZIP format)
Download PDF files with example analysis (PDF format):
Tube 1 Analysis
Tube 2 Analysis
Tube 3 Analysis
Download/View Case discussion (Powerpoint format)
David Grier, MD
Wake Forest University School of Medicine,
Winston-Salem, NC, USA
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Would You Like to Contribute a Case Study?
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You will need to provide:
1. A brief case history including demographic data, specimen type, relevant clinical history, and indication for study.
2. A list of the tubes selected for review with the antibodies and fluorochromes used.
3. Selected anonomized list mode files to post on the ICCS website. List mode files should be labeled with a key detailing antibodies and fluorochromes used, the format in which files were collected (FCS2.0 or FCS3.0, eg) and the software used for collection.
4. PDF files for each tube selected, showing an example of what a correct and complete analysis should look like.
5. A Powerpoint presentation summarizing your case, to include a description of a recommended analysis strategy, the flow cytometric pertinent findings, and their significance.
6. A passport-style photo of each author.
7. A signed web consent form.
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