|
| Test | Result |
|
| Bone marrow biopsy results |
| Flow cytometry | No evidence of acute leukemia or increased blasts |
| CD25 | Positive |
| CD68 | Weakly positive |
| CD117 | Positive |
| CD3, CD5, CD10, CD20, CD34, MPO, TDT, cyclin D1, DBA-4A, BCL6 | Negative |
| Ki67 | 5% |
| Full-leukemia panel for translocation | Negative |
| Karyotype | 46 XX |
| Histology | 90% cellular bone marrow
Diffuse population of medium-sized cells with round to kidney-shaped nuclei, and moderate to abundant cytoplasm with retraction, seen surrounding aggregates of small lymphocytes and admixed with increased eosinophils |
|
| Blood test done while on midostaurin 2 weeks prior to presentation: |
| CBC | Hb: 10.3 g/dL
MCV: 103.7 fL
WBCs: 4100/µL | Neutrophils: 70%
Lymphocytes: 21% | Eosinophils: 4%
Platelets: 117000/µL |
|
| Blood test in the ED on presentation |
| CBC | Hb: 7.8 g/dL
MCV: 104.2 fL
WBCs: 3500/µL | Neutrophils: 74%
Lymphocytes: 15% | Eosinophils: 3%
Platelets: 75000/µL |
| CRP | 172 mg/dL |
| ESR | 119 mm/h |
| Procalcitonin | 0.45 ng/mL |
|
| Urine studies in the ED on presentation |
| Urine analysis | WBCs: numerous; RBCs: 2–4
Leukocyte esterase: negative; nitrites: negative; squamous epithelia: present casts: negative; crystals: negative; bacteria: negative |
| Urine culture | Negative |
|
| Infectious workup during admission |
| PCR (parvovirus, adenovirus, chlamydia, gonorrhea, TB) | Not detected |
| Bacterial culture | Negative |
| Fungal culture | Negative |
| AFB smear | Negative |
| 16S RNA | Negative |
| Synovial fluid analysis | RBCs: 5610/µL; WBCs: 1230/µL; N: 77%; L: 12%; Mono: 8%; Eo: 3% |
| Synovial fluid polarizing microscopy | No crystals seen
Many RBCs and 10–15 WBCs |
|
