Correlation of Cytomorphology with Flowcytometric Immunophenotyping of Acute Myeloid Leukemia in Tertiary Care Hospital

Introduction: WHO classification utilizes morphology,genetic information, immunophenotyping, biologic andclinical features to define specific disease entity. Althoughit gives an accurate detailed diagnosis, immunophenotypingby flow cytometry gives an immediate prompt diagnosis.Morphological diagnosis for leukemias may sometimes be notcorrelating with flow cytometry diagnosis. Study objectiveswere to correlate morphological and flowcytometric results ofpatients diagnosed with acute myeloid leukemias.Material and methods: Study was conducted in departmentof pathology. Cases were classified as Acute leukemia basedon CBC, peripheral smear, bone marrow morphology, specialstains cytochemistry and Flow cytometry Immunophenotyping.Categorization was done based FAB system.Results: Total 92 cases of AML were diagnosed oncytomorphology, cytochemistry and Flow cytometry werestudied. Out of which M0 were 6.5%, M1-13%, M2-27.2%,M3-17.4%, M4-15.2% and M5 were 20.6%. There was 88%correlation between cytomorphology and flowcytometry.Conclusion: Interpretation of immunophenotyping byflowcytometry, done in close conjunction with morphology,is mandatory for appropriate diagnosis of acute myeloidleukemia. However morphology combined with cytochemistryis also very helpful in the diagnosis of AML if facility offlowcytometry is not available

Extramedullary Plasmacytoma of Breast.

Solitary plasmacytomas are more frequent in males than females. We are describing a solitary extramedullary plasmacytoma of the breast in a 50 year old woman on fine needle aspiration cytology and confirmed on histology. During 6 months of fallow up, no other involvement was detected in the bone marrow or in any other site. Extramedullary plasmacytoma occur in lymph node, lung, thyroid, gastrointestinal tract testis, and skin. Extramedullary plasmacytoma of breast is a rare lesion. Especially those are not associated with multipal myeloma. Most reported cases represent secondary involvement or initial manifestation of the multipal myeloma.

Synovial Cyst with Fungal Granuloma.

Synovial cysts are frequently seen and are most commonly seen at the back of the knee where it is known as popliteal cyst. But synovial cyst with fungal granuloma is rather rare. This case report illustrates an occurrence of synovial cyst with fungal granuloma, in a 40 years old male at the dorsal aspect of the right ankle joint. Clinical examination revealed lesion about 4x4x4cms in size over the dorsal aspect of the right ankle joint. Simple excision of the lesion was done with the clinical diagnosis of lipoma. Microscopic examination revealed synovial lining hyperplasia and subintimal tissue showed granulomatous reaction with foreign body giant cells and black colored fungal colonies. Patients did not attend further, so follow up was not available.