Flow Cytometry: Quiz Cases: Nitin Karandikar, MD, PHD

Flow Cytometry: Quiz Cases
Here are 30 quiz cases

In most cases, a brief history is provided [age/sex/specimen],
followed by flow cytometric findings
In the flow cytometry dotplots, each color represents a specific
population of cells
All populations are always shown the forward/side scatter dotplot so
that size and granularity can be seen (compared to a lymphocyte
population, which is always included)
Based on the markers shown, try to identify what each population
In most cases, the red population is of major interest [although other
populations may also provide clues toward the diagnosis]
Try to come up with an interpretation on every case. We will discuss
them together during my presentation
Nitin Karandikar, MD, PhD
Case 1: 55 Year Old Man; Peripheral Blood
Case 1
Green: T cells; Blue: Polytypic B cells; Red: ?
Case 2: 67 Year Old

Man; Peripheral Blood
IP2012-00056
Case 2
Green: T cells; Red: ?
IP2011-01054
Case 3
Forward
Scatter
256
512
768
100
1024
CD10
102
103
104
CD38
100
101
CD20
102
103
104
CD20 PerCP ->

A-11-1054 DIETER JR07.004
100
CD10 FITC ->

A-11-1054 DIETER JR07.001
CD23
Forward Scatter ->

A-11-1054 DIETER JR07.005
101
101
CD5
102
103
104
CD5 PerCP-Cy5.5 ->

A-11-1054 DIETER JR07.005
Kappa
CD19
CD19
Orthogonal Scatter
IP2011-01054
100
101 FMC-7
102
103
104
FMC7 FITC ->

A-11-1054 DIETER JR07.006
100
101Lambda
102
103
104
p.Lambda FITC ->

A-11-1054 DIETER JR07.005
Green: T cells; Blue: Polytypic B cells; Red: ?
Case 4: 60 Year Old Woman; Peripheral Blood

IP2011-02757
Case 4
Forward
Scatter
256
512
768 1024
100
CD10
102
103
104
CD38
100
101
CD20
102
103
104
CD20 PerCP ->

A-11-2757 HALL09.004
100
CD10 FITC ->

A-11-2757 HALL09.001
CD23
Forward Scatter ->

A-11-2757 HALL09.005
101
101
CD5
102
103
104
CD5 PerCP-Cy5.5 ->

A-11-2757 HALL09.005
Kappa
CD19
CD19
Orthogonal Scatter
IP2011-02757
100
101 FMC-7
102
103
104
FMC7 FITC ->

A-11-2757 HALL09.006
100
101Lambda
102
103
104
p.Lambda FITC ->

A-11-2757 HALL09.005

IP2010-02759
Case 5
Case 6: 53 Year Old Woman; Lymph Node
Case 6
Case 7: 64 Year Old Woman; Gastric Biopsy

IP2010-02634
Case 7
Forward
Scatter
256
512
768 1024
100
CD10
102
103
104
CD19
100
101
CD5
102
103
104
CD5 PerCP-Cy5.5 ->

A-10-2634 BROWN01.005
100
CD10 FITC ->

A-10-2634 BROWN01.001
CD23
Forward Scatter ->

A-10-2634 BROWN01.005
101
101 CD38
102
103
104
CD38 PE ->
A-10-2634 BROWN01.001
Kappa
CD20
CD19
Orthogonal Scatter
IP2010-02634
100
101 FMC-7
102
103
104
FMC7 FITC ->

A-10-2634 BROWN01.006
100
101Lambda
102
103
104
p.Lambda FITC ->

A-10-2634 BROWN01.005
Case 8: 59 Year Old Man; Bone Marrow

IP2010-01670
Case 8

IP2011-05081
Case9
Case 10: 50 Year Old Man; FNA Right Neck Mass

IP2010-02525
Case 10
Forward
Scatter
256
512
768 1024
100
101
CD10
102
103
104
CD19
100
101
CD5
102
103
CD5 PerCP-Cy5.5 ->

L-10-2525 KEANE.006
100
CD10 FITC ->

L-10-2525 KEANE.001
104
101 CD20
102
103
104
CD20 PerCP ->

L-10-2525 KEANE.001
CD23
Forward Scatter ->

L-10-2525 KEANE.006
Kappa
CD38
CD19
Orthogonal Scatter
IP2010-02525
100
101 FMC-7
102
103
FMC7 FITC ->

L-10-2525 KEANE.006
104
100
101Lambda
102
103
p.Lambda FITC ->

L-10-2525 KEANE.005
104
Case 11: 40 Year Old Man; Axillary Lymph Node

IP2008-03188
Forward
Scatter
256
512
768 1024
100
CD10
102
103
104
CD19
100
101
CD5
102
103
104
CD5 PerCP-Cy5.5 ->

L-08-3188 BARRY11.006
100
CD10 FITC ->

L-08-3188 BARRY11.001
CD23
Forward Scatter ->

L-08-3188 BARRY11.006
101
101 CD20
102
103
104
CD20 PerCP ->

L-08-3188 BARRY11.001
Lambda
CD38
CD19
Orthogonal scatter
Case
11
IP2008-03188
100
101 FMC-7
102
103
104
FMC7 FITC ->

L-08-3188 BARRY11.006
100
101 Kappa
102
103
104
m.Kappa FITC ->

L-08-3188 BARRY11.004
Case 12: 53 Year Old Woman; Bone Marrow

IP2010-02834
Forward
Scatter
256
512
768 1024
100
CD10
102
103
104
CD45
100
101
CD56
102
103
104
CD56 PE ->
A-10-2834 KIGHT11.002
100
CD10 FITC ->

A-10-2834 KIGHT11.001
Lambda
Forward Scatter ->

A-10-2834 KIGHT11.001
101
101 CD20
102
103
104
CD20 PerCP ->

A-10-2834 KIGHT11.001
Intracellular Lambda
CD38
CD19
Orthogonal Scatter
Case
12
IP2010-02834
100
101 Kappa
102
103
104
m.Kappa FITC ->

A-10-2834 KIGHT11.004
100 Intracellular
101
102
103
104
Kappa
IC m.Kappa FITC ->

A-10-2834 KIGHT ICS12.001
Case 13: 17 Year Old Boy; Bone Marrow

IP2010-02371
Case13
0
256
512
768
1024
100
101
102
103
104
100
101
CD10
Forward Scatter
102
103
104
103
104
CD20
Green: Granulocytes
Blue: B lymphocytes
Black: monocytes
Red: ?
100
101
102
103
104
100
101
101
102
CD45
103
104
100
101
102
CD15
103
104
103
104
CD13
CD10
100
102
100
101
102
TdT
100
101
102
Surface Lambda
103
104
100
101
102
103
Myeloperoxidase
104
Case 14: 5 Year Old Girl; Bone Marrow
Case 14
Orthogonal Scatter
IP2011-00039
1024
CD45
102
103
CD34
CD19
101
104
CD45 PerCP ->

A-11-0039 STRAND04.002
101
CD45
102
CD34
2
CD10
1010
103
2
101 CD10
103
104
100
101HLA-DR
102
103
104
101
104
CD10 CD10
FITCFITC
-> ->
A-11-0039 STRAND04.001
A-11-0039
STRAND04.001
CD38
CD38
100
100
100
CD19
Forward Scatter -> Forward Scatter ->

A-11-0039 STRAND04.001
A-11-0039 STRAND04.001
100
103
104
CD45 PerCP ->

A-11-0039 STRAND04.002
100
101 CD20
102
CD20
10110
102
4
103
103
104
CD20 PerCP CD20

->
PerCP
A-11-0039 STRAND04.001
100
Anti-HLA-DR PerCP ->

A-11-0039 STRAND04.010
100
100
->
A-11-0039 STRAND04.001
101HLA-DR
102
103
CD22
Forward
Scatter
256
512
768
1024512
Scatter
0 Forward
256
768
CD22
CD22
Orthogonal Scatter
CD22
IP2011-00039
101
102
TdT
103
104
TdT FITC ->

A-11-0039 STRAND TDT.002
104
Anti-HLA-DR PerCP ->

A-11-0039 STRAND04.010
100
101
102
TdT
103
104
TdT FITC ->

A-11-0039 STRAND TDT.002
Case 15
Green: Granulocytes
Blue: B lymphocytes
Red: ?
256
512
768
1024
Forward Scatter
100
102
10
103
100
104
101
101
102
103
104
100
101
103
Surface Lambda
104
100
101
102
CD45
102
103
104
100
101
CD13
CD10
CD20
100
102
103
104
100
101
102
TdT
102
103
104
103
104
CD15
103
104
100
101
102
Myeloperoxidase
Case 16: 62 Year Old Woman; Bone Marrow

IP2010-04445
Orthogonal Scatter
Case 16
IP2010-04445
256
512
768 1024
Forward
Scatter
100
101
102
CD10
103
104
CD19
100
101
102
CD20
103
104
CD33
100
101
CD15
102
103
104
CD15 FITC ->

A-10-4445 JARRETT01.008
100
CD20 PerCP ->

A-10-4445 JARRETT01.001
CD79a
CD10 FITC ->

A-10-4445 JARRETT01.001
101 CD20
102
103
104
CD20 PerCP ->

A-10-4445 JARRETT01.004
HLA-DR
CD22
CD34
Forward Scatter ->

A-10-4445 JARRETT01.001
100
101
102
103
Myeloperoxidase
104
Anti-Myeloperoxidase ( ->
A-10-4445 JARRETT MPO03.002
100
101
102
CD13
103
104
CD13 PE ->
A-10-4445 JARRETT01.010
Case 17: 6 Month Old boy; Peripheral Blood

IP2009-02707A
Case 17
Case18:
18yearoldman
Anterior
Medias6nal
Mass
100
101
102
103
101
102
103
CD7 FITC
512
768
1024
100
Forward Scatter
104
100
104
101
102
103
100
101
102
101
102
103
104
104
100
101
102
103
CD45 PerCP
104
100
101
102
CD5 PE
103
101
102
103
104
103
104
CD8 FITC
104
CD10 FITC
103
100
CD1a PE
TdT FITC
TdT FITC
100
256
100
101
102
Surface CD3 PerCP
104
100
101
102
103
CD2 FITC
104
Case 19: 31 Year Old Man; Right Pleural Fluid
Case 19
256
512
768
1024
FSC-Height -
100
101
102
103
104
TdT FITC ->
100
101
100
101
102
CD7 FITC ->
103
104
100
101
102
CD45 PerCP ->
101
102
103
104
CD1a PE ->
103
104
100
103
104
100
CD34 FITC ->
102
100
101
101
101
102
103
104
102
103
104
CD4 PE ->
102
103
104
100
103
104
100
CD10 FITC ->
CD5 PE ->
100
102
101
Surface CD3 FITC ->
101
CD2 PE ->
102
103
104
Case 20: 15 Year Old Girl; Bone Marrow

IP2009-03070A
Case20
0
100
101
102
103
104
CD45 PerCP ->
100
101
102
CD7 FITC ->
103
104
100
101
102
103
104
101
512
768
Forward Scatter
101
102
1024
103
102
CD2 FITC ->
103
104
100
101
102
100
101
102
103
104
102
103
104
102
103
104
TdT FITC ->
104
CD8 FITC ->
CD1a PE ->
100
100
256
100
101
CD5 PE ->
103
Anti-Myeloperoxidase ->
104
100
101
CD13 PE ->
Case 21: 52 Year Old Woman; Lymph Node

IP2012-04043
Case 21
0
256
512
768
1024
Forward Scatter ->
100
101
102
103
104
CD7 FITC ->
100
101
102
CD3 PerCP ->
100
101
102
103
104
100
101
102
CD10 FITC ->
101
102
103
104
CD45 PerCP ->
104
CD5 PerCP ->
103
100
100
101
102
104
100
101
101
102
103
104
102
103
104
CD2 PE ->
103
104
100
101
Anti-TCR-alpha-beta-1
CD4 PE ->
103
100
102
CD52 FITC ->
103
104
100
101
CD1a PE ->
102
103
104

IP2010-04252
Case 22
Forward
Scatter
256
512
768 1024
100
Forward Scatter ->

L-10-4252 ROSALES01.008
101
CD34
102
103
104
100
101
CD13
102
103
104
CD13 PE ->
L-10-4252 ROSALES01.010
100
CD34 FITC ->

L-10-4252 ROSALES01.002
101 CD15
102
103
104
CD15 FITC ->

L-10-4252 ROSALES01.008
CD117
CD79a
HLA-DR
CD33
CD14
Orthogonal Scatter
IP2010-04252
100
101
102
103
Myeloperoxidase
104
Anti-Myeloperoxidase ( ->
L-10-4252 ROSALES MPO02.002
100
101
102
CD2
103
104
CD2 FITC ->

L-10-4252 ROSALES01.009

IP2010-00717
Case 23
0
256
512
768
1024
101
102
103
104
CD15 FITC ->
100
101
102
CD20 PerCP ->
101
102
103
104
100
101
102
103
104
104
100
101
TdT FITC ->
101
102
103
104
100
101
102
103
104
103
104
CD45 PerCP ->
CD13 PE ->
103
100
CD117 PE ->
CD34 FITC ->
Forward Scatter ->
100
100
102
103
104
100
101
102
Anti-Myeloperoxidase ( -
Case 24
Case 25: 65 Year Old Male; Bone Marrow
Case 25
Case 26
256
512
768
1024
Forward Scatter
100
101
102
CD117
103
104
100
101
102
CD2
103
256
512
768
1024
Orthogonal Scatter
104
100
101
102
CD25
103
104
Case 26
Case 27: 14 Year Old Boy; Axillary Lymph Node
IP2008-01689
CD45
CD3
Orthogonal scatter
Case 27
IP2008-01689
Forward
Scatter
256
512
768 1024
100
CD30
102
103
104
101
CD5
102
103
104
CD5 PE ->
C-08-1689 CAMPOS.010
101 CD13
102
103
104
CD13 PE ->
C-08-1689 CAMPOS.011
HLA-DR
CD4
100
100
CD30 FITC ->

C-08-1689 CAMPOS.010
CD45RO
Forward Scatter ->

C-08-1689 CAMPOS.010
101
100
101
102
CD26
103
104
CD26 PE ->
C-08-1689 CAMPOS.013
100
101
102
CD25
103
104
CD25 PE ->
C-08-1689 CAMPOS.015
Case 28: 59 Year Old Man; Paracentesis Fluid
IP2008-04936
Case 28
Forward
Scatter
256
512
768 1024
100
101
CD5
102
103
104
CD38
100
101
CD20
102
103
104
CD20 PerCP ->

A-08-4936 BRIDGES01.001
100
CD5 PerCP ->

A-08-4936 BRIDGES01.005
Lambda
Forward Scatter ->

A-08-4936 BRIDGES01.005
101 CD30
102
103
104
CD30 FITC ->

A-08-4936 BRIDGES.008
Intracellular Lambda
CD71
CD19
Orthogonal scatter
Other relevant markers: CD45(+), CD2(-), CD3(-), CD4(-), CD7(-), CD8(-),CD10(-), CD23(-),
CD56(-), FMC-7(-)
IP2008-04936
100
101 Kappa
102
103
104
m.Kappa FITC ->

A-08-4936 BRIDGES01.004
100 Intracellular
101
102
103
104
Kappa
IC m.Kappa FITC ->

A-08-4936 BRIDGES.009
Case 29: 42 Year Old Woman; Peripheral Blood

IP2011-02023
Case 29
CD45RO
CD3
Orthogonal Scatter
IP2011-02023
Forward
Scatter
256
512
768 1024
100
CD2
102
103
104
CD8
100
101
CD4
102
103
104
CD4 PE ->
A-11-2023 BOOKER09.007
100
CD2 FITC ->

A-11-2023 BOOKER09.002
CD26
Forward Scatter ->

A-11-2023 BOOKER09.007
101
101
CD3
102
103
104
CD3 PerCP ->

A-11-2023 BOOKER09.002
TCR gamma/delta
100
101
102
CD7
103
104
CD7 FITC ->

A-11-2023 BOOKER10.001
100
101 alpha/beta
102
103
TCR
104
Anti-TCR-alpha-beta-1 ->
L-11-2023 BOOKER.015
Case 30: 3 Day Old Boy; Peripheral Blood

IP2009-02707
Case 30
0
256
512
768
1024
Forward Scatter ->
100
101
102
103
104
CD61 FITC ->
100
101
102
CD7 FITC ->
100
101
102
104
100
101
102
CD71 FITC ->
101
102
103
104
103
104
103
104
100
101
102
103
104
CD13 PE ->
100
101
100
101
102
103
104
103
104
103
104
CD15 FITC ->
CD34 FITC ->
CD36 FITC ->
103
100
100
101
102
CD45 PerCP ->
102
CD41 FITC ->
103
104
100
101
CD56 PE ->
102

Flow Cytometry: Quiz Cases: Nitin Karandikar, MD, PHD

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Flow Cytometry: Quiz Cases

Here are 30 quiz cases

Nitin Karandikar, MD, PhD

Case 1: 55 Year Old Man; Peripheral Blood

Green: T cells; Blue: Polytypic B cells; Red: ?

Case 2: 67 Year Old

Green: T cells; Red: ?

Case 3: 53 Year Old Man; Peripheral Blood

CD20 PerCP ->

CD10 FITC ->

Forward Scatter ->

CD5 PerCP-Cy5.5 ->

FMC7 FITC ->

p.Lambda FITC ->

Green: T cells; Blue: Polytypic B cells; Red: ?

Case 4: 60 Year Old Woman; Peripheral Blood

CD20 PerCP ->

CD10 FITC ->

Forward Scatter ->

CD5 PerCP-Cy5.5 ->

FMC7 FITC ->

p.Lambda FITC ->

Case 5: 72 Year Old Man; Peripheral Blood

Case 6: 53 Year Old Woman; Lymph Node

Case 7: 64 Year Old Woman; Gastric Biopsy

CD5 PerCP-Cy5.5 ->

CD10 FITC ->

Forward Scatter ->

FMC7 FITC ->

p.Lambda FITC ->

Case 8: 59 Year Old Man; Bone Marrow

Case 9: 47 Year Old Man; Bone Marrow

Case 10: 50 Year Old Man; FNA Right Neck Mass

CD5 PerCP-Cy5.5 ->

CD10 FITC ->

CD20 PerCP ->

Forward Scatter ->

FMC7 FITC ->

p.Lambda FITC ->

Case 11: 40 Year Old Man; Axillary Lymph Node

CD5 PerCP-Cy5.5 ->

CD10 FITC ->

Forward Scatter ->

CD20 PerCP ->

FMC7 FITC ->

m.Kappa FITC ->

Case 12: 53 Year Old Woman; Bone Marrow

CD10 FITC ->

Forward Scatter ->

CD20 PerCP ->

m.Kappa FITC ->

IC m.Kappa FITC ->

Case 13: 17 Year Old Boy; Bone Marrow

Case 14: 5 Year Old Girl; Bone Marrow

CD45 PerCP ->

Forward Scatter -> Forward Scatter ->

CD45 PerCP ->

CD20 PerCP CD20

Anti-HLA-DR PerCP ->

TdT FITC ->

Anti-HLA-DR PerCP ->

TdT FITC ->