Extensive bone marrow infiltrate by neoplastic cells (hematoxylin and eosin, 400x and 1000x(insert))Extensive bone marrow infiltrate by neoplastic cells (hematoxylin and eosin, 400x and 1000x(insert))
Bone marrow aspirate smear morphology (Wright-Giemsa, 1000xBone marrow aspirate smear morphology (Wright-Giemsa, 1000x
Neoplastic cells demonstrating CD19 positivity (400x)Neoplastic cells demonstrating CD19 positivity (400x)
Neoplastic cells demonstrating CD10 positivity (400x)Neoplastic cells demonstrating CD10 positivity (400x)
. Neoplastic cells demonstrating partial TdT positivity (400x, insert showing loss of TdT expression on neoplastic cells in relapse specimen). Neoplastic cells demonstrating partial TdT positivity (400x, insert showing loss of TdT expression on neoplastic cells in relapse specimen)
Neoplastic cells demonstrating partial MUM1 positivity (400x, insert showing loss of MUM1 expression on neoplastic cells in relapse specimen)Neoplastic cells demonstrating partial MUM1 positivity (400x, insert showing loss of MUM1 expression on neoplastic cells in relapse specimen)
Neoplastic cells demonstrating high proliferation index Ki-67 (400x)Neoplastic cells demonstrating high proliferation index Ki-67 (400x)
Small subset of neoplastic cells demonstrating CD20 positivity in relapsed specimen (400x)Small subset of neoplastic cells demonstrating CD20 positivity in relapsed specimen (400x)
CD34 immunostain highlights vessels with CD34 negative neoplastic cells in background (400x) CD34 immunostain highlights vessels with CD34 negative neoplastic cells in background (400x)
cMYC immunostain demonstrates strong nuclear staining in ~40% of neoplastic cells (400x)cMYC immunostain demonstrates strong nuclear staining in ~40% of neoplastic cells (400x)