Pathology Playground: Crowd Unknowns
Below are pathology unknowns cases in which you can order immunostains and molecular studies. Choose your case, and when presented with a text box, begin typing the immuno or other study you'd like, and select it from the Autocomplete list. Enter your diagnosis to see if you're correct and see a presentation. If you want to upload your own cases, Login at the top right and go to the Dashboard. Watch a Youtube video on how to use the site and upload your own cases here.
Lymphocytosis in middle age patient
61-year-old male presented with leukocytosis to primary care physician. CBC result, representative cells from differential and representative bone marrow are provided. Work up (including immunohistochemistry on tissue, flow cytometry, karyotype, FISH, and molecular), morphology guide for blood smear and flow cytometry guide are available under "specials to order".
Atypical lymphocytes on blood smear
62-year-old woman admitted to the hospital with severe pneumonia and found to have leukocytosis with atypical lymphocytes/ monocytes on blood smear. CBC result, representative cells from differential and representative bone marrow are provided. Work up (including immunohistochemistry on tissue, flow cytometry, karyotype, FISH, and molecular), morphology guide for blood smear and flow cytometry guide are available under "specials to order".
Blasts versus atypical monocytes
62-year-old woman admitted with worsening dyspnea on exertion and found to have leukocytosis. CBC result, representative cells from differential and representative bone marrow are provided. Work up (including immunohistochemistry on tissue, flow cytometry, karyotype, FISH, and molecular), morphology guide for blood smear and flow cytometry guide are available under "specials to order".
Possible blasts in blood
77-year-old man with history of chronic pancytopenia and macrocytosis. No prior therapy. 7% Atypical cells were noted in the differential count (see images).CBC result, representative cells from differential and representative bone marrow are provided. #Note: Subclassification is required. Work up (including immunohistochemistry on tissue, flow cytometry, karyotype, FISH, and molecular), morphology guide for blood smear and flow cytometry guide are available under "specials to order".
Atypical cells on blood smear
66-year-old man with history of asthma, intermittent fever and borderline leukocytosis. CBC result, representative cells from differential and representative bone marrow are provided. Note: Subclassification is required. Work up (including immunohistochemistry on tissue, flow cytometry, karyotype, FISH, and molecular), morphology guide for blood smear and flow cytometry guide are available under "specials to order".
Neutrophilia with left shift.
51-year-old women admitted with worsening lower back pain and found to have severe leukocytosis. Work up (including immunohistochemistry on tissue, flow cytometry, karyotype, FISH, and molecular), morphology guide for blood smear and flow cytometry guide are available under "specials to order".
Back pain from a compression fracture
58-year-old man with acute on chronic back pain and found to have compression fracture L2. Lab findings are shown, and bone marrow biopsy was performed. Representative cells from marrow aspirate smears and representative bone marrow are provided. Work up (including immunohistochemistry on tissue, flow cytometry, SPEP, free light chains, karyotype, FISH, and molecular), morphology guide for blood smear and flow cytometry guide are available under "specials to order".
Large stomach mass
80-year-old male with dyspeptic symptoms. Endoscopy shows a large elevated mass in 1/3 of the gastric fundus