—  SPECIALTY CONFERENCE  — Hematopathology Wednesday, March 21, 2012, 7:30 PM Convention Centre 211-214 Click the button above to add this event to your Itinerary Planner... Leaving Lymphomas: Loving Leukemias and Making-Out with Myeloid Malignancies Moderator: ADAM BAGG Univ of Pennsylvania Philadelphia, PA Disclosure: In accordance with ACCME guidelines regarding disclosure, the USCAP policy requires that faculty members who have a significant financial or other relationship with a commercial company, entity, or service (which will be discussed in this Symposium) must disclose this to attendees. The Academy also requires that speakers disclose any products that are not labeled for the use under discussion. The speakers listed below have indicated they have nothing to disclose. Panelists: Daniel A. Arber, Stanford Univ Med Ctr, Stanford, CA Sa Wang, UT MD Anderson Cancer Ctr, Houston, TX Attilio Orazi, Weill Medical Coll/Cornell Univ, New York, NY Clinical histories are displayed below. For the fastest viewing of virtual slides, click: under each thumbnail image below. You must have Aperio ImageScope installed on your PC. If you do not already have Aperio ImageScope, Windows users with administrator privileges may download and install a free version in order to view USCAP Virtual Slides. Click the icon on the right to get your free copy:   Or, click on slide thumbnail images to view each slide in a Web-based slide viewer, which is somewhat slower. If you have any difficulties viewing these slides, email or call George Clay at +1.724.449.1137. Case 1 Submitted by: Daniel A. Arber - Stanford Univ Med Ctr, Stanford, CA Clinical Summary: This 48 year old woman presented to her primary care physician with complaints of fatigue. A CBC was performed with the following results: WBC: 10.5 K/uL HGB: 8.9 g/dL HCT: 25.9 % MCV: 91.1 fL PLT: 203 K/uL RDW: 20.1 %. Review of the peripheral blood smear showed 79% blasts. She was referred to a hematologist for bone marrow examination. Submitted is a bone marrow aspirate smear and trephine biopsy. Case 1 - Slide 1 Click to view with ImageScope Click to view with a Web-Based Viewer Case 1 - Slide 2 Click to view with ImageScope Click to view with a Web-Based Viewer Case 2 Submitted by: Sa Wang - UT MD Anderson Cancer Ctr, Houston, TX Clinical Summary: An 84-year-old-woman, with a history of an artificial heart valve, noticed significant fatigue and paleness in May 2009. She received red cell transfusion, and a bone marrow (BM) biopsy and aspirate (not shown) was performed. A CBC at the time of BM biopsy showed: WBC: 2.3 (70% neutrophils, 28% lymphocytes and 2% monocytes); Hb: 6.8 (MCV 92); Platelets: 32. A diagnosis of refractory cytopenia with multilineage dysplasia was made. She received 5-azacitidine from September 2009 to July 2010 with an initially significant improvement in transfusion dependency. In August 2011, her counts deteriorated. A CBC at this visit showed: WBC: 0.6 (12.5% neutrophils, 82.5% lymphocytes and 5% eosinophils); Hb: 7.1 (MCV 94); Platelets: 19. Another bone marrow was performed. Case 2 - Figure 1 BM biopsy 50x Case 2 - Figure 2 BM biopsy 100x Case 2 - Figure 3 BM crush Case 2 - Figure 4 BM smear Case 2 - Figure 5 CD34 Case 2 - Figure 6 E-cadherin-2 Case 2 - Figure 7 glycophorin Case 2 - Figure 8 iron Case 3 Submitted by: Attilio Orazi - Weill Medical Coll/Cornell Univ, New York, NY Clinical Summary: 35 year old man History of mild thrombocytosis for few years To investigate the possibility of MPN, referred to WCMC/NYPH in November 2007. No splenomegaly/organomegaly. Pertinent Laboratory Data: CBC(11/1/07)showed: Hb 13.1 g/dL Hct 39.5 % MCV 80.5 fL WBC 6.5 x109/L (N, 68; Ly 18; Mo 11; Eo 2, Ba 1) Plts. 483 x109/L P.B. smears (not available) showed only mild anisopoikilocytosis and thrombocytosis. Other results: LDH 248 U/L ( 96-200 U/L) JAK2V617F mutation present Red Cell Mass within normal range EPO normal Flow cytometry unremarkable Normal karyotype BCR-ABL1 absent (FISH) TCR gamma and IgH chain gene(PCR) negative Case 3 - Slide 1 Click to view with ImageScope Click to view with a Web-Based Viewer Case 3 - Figure 1 touch prep Case 3 - Figure 2 Case 3 - Figure 3 Case 3 - Figure 4 Case 3 - Figure 5 Case 3 - Figure 6 Case 3 - Figure 7 Case 3 - Figure 8 Reticulin MF-0 to MF-1 Handouts for all Specialty Conferences will be accessible via the "Educational Materials" section on the homepage the morning after each respective conference. Printed copies of the handout will not be available at the meeting.