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Blastic plasmacytoid dendritic cell neoplasm: cytopathologic findings
Gang Zheng1, John Schmieg, Hui Guan
1Department of Pathology, The Johns Hopkins Hospital, Baltimore, Md. 21205, USA.
Acta Cytologica
|March 2, 2012
Summary
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare cancer. This report details its cerebrospinal fluid cytology and flow cytometry findings in a patient case.
Area of Science:
- Hematology
- Oncology
- Cytopathology
Background:
- Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematologic malignancy.
- Previously known by various names including blastic NK cell lymphoma and CD4+/CD56+ hematodermic neoplasm.
- Etiology remains unknown, though it is thought to originate from plasmacytoid dendritic cells.
Observation:
- This study reports on the cerebrospinal fluid (CSF) cytology of a BPDCN case.
- The CSF specimen was hypercellular with malignant cells exhibiting specific morphological features.
- Morphological characteristics included scant cytoplasm, round to oval nuclei, fine chromatin, and prominent nucleoli.
Findings:
- Flow cytometry analysis of CSF revealed malignant cells with a distinct immunophenotype.
- Key markers included bright CD45, HLA-DR, CD33, dim CD4, heterogeneous CD56, and partial CD123.
- Absence of mitoses and karyorrhexis was noted in the observed cells.
Implications:
- Accurate diagnosis and reporting of BPDCN in CSF are crucial due to the poor clinical outcome.
- Emphasizes the importance of correlating clinical, histopathological, and phenotypic data for diagnosis.
- Highlights the utility of CSF cytology and flow cytometry in diagnosing rare hematologic neoplasms.
