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.

tag: heme

Bone marrow

70 y/o male, gout, diabetes, monoclonal gammopathy, diarrhea

Lung

27 yo F w acute pneumothorax

Bone marrow

31 yo M w CBC abnormalities

Neck mass

37 yo M supraclavicular neck mass

Neck mass

81 yo R neck mass

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".

Skin

85 yo F, no hx provided

Large stomach mass

80-year-old male with dyspeptic symptoms. Endoscopy shows a large elevated mass in 1/3 of the gastric fundus

Small bowel mass

50 yo M with small bowel obstruction