Agranular CD4+/CD56+ cutaneous neoplasm.

CD4+ CD56+ cutaneous neoplasm with hematological relapse is a rare malignant disease and has been described recently in the literature as blastic or agranular NK-cell leukemia/lymphoma. The origin of this neoplasm is uncertain. We describe a 75-year-old patient with a primary cutaneous neoplasm CD4+ CD56+ who evolved to leukemic phase despite standard lymphoma chemotherapy. Morphologically, the cells were undifferentiated without granules in the cytoplasm. The immunophenotype showed the expression of CD4, CD56, CD68, CD33, CD7, CD2, CD45RA, and CD38. Histological analysis revealed a cell infiltration mainly located in the dermis. T-cell receptor and immunoglobulin heavy chain genes were in germline configuration. Cytogenetic study showed complex structural abnormalities with a deletion of the chromosome 5 del(5q). The clinical course was aggressive with an early hematological relapse.

[Evaluation of the Beckman Coulter HmX hematology analyser at a general hospital]. / Evaluation de l'analyseur d'hématologie Beckman Coulter HmX dans un hôpital général.

The Beckman Coulter HmX is an hematological analyzer designed to provide a complete hematological profile including CBC, WBC differential (diff) and reticulocyte parameters. It has been evaluated in our laboratory over a two weeks period with three purposes: (1) a technical evaluation of the HmX performance, in regard to repeatability, linearity, carry over; (2) a comparison of numerical results (CBC, WBC diff) and analytical performance (flag sensitivity and specificity) with those obtained with the Coulter MaxM in use in our laboratory; (3) an analysis of the flagging algorithms using the blood smear as the reference method. The first part of the evaluation showed that the Beckman Coulter HmX is reproducible, and linear. The comparison between MaxM and HmX showed that the results given by the two instruments are similar and suggested that the Beckman Coulter HmX could replace the current hematology analyzer in use in our laboratory. The comparison of the flag system performance, between the Beckman Coulter HmX and the Coulter MaxM, has been performed with samples from three subgroups of patients (general departments, surgery and intensive care, hematological unit), and showed that the HmX is significantly more sensitive than the MaxM, with an higher global efficiency. The comparison of predictive values also showed a better performance of the HmX. In conclusion, the Beckman Coulter HmX is suited for an use in medium sized hospital laboratories (80 to 150 CBC diff/day), with good technical and analytical performance, a throughput of 75 samples/hr and a workstation allowing data management in accord with quality assurance guidelines in France.

Automated detection of malaria by means of the haematology analyser Coulter GEN.S.

The haematology analysers Coulter(R) GEN.S(TM) and LH(TM) give a set of data--'positional parameters'--which define each WBC population by mean of index values, the mean and the standard deviation (SD) of volume, conductivity and scatter, used to identify the WBC populations. These parameters were analysed in patients investigated for suspicion of malaria, in order to show a difference between malaria negative and malaria positive patients and to use it for malaria detection. The six parameters exhibiting a significant difference between the two groups were submitted to a ROC analysis, which showed both sensitivity >90% and specificity >60% for two parameters, lymphocyte and monocyte SDs of volumes. A discriminator combining the two parameters showed a sensitivity of 96.9% and a specificity of 82.5%. The cut off of the discriminative value was calculated. Because of the good stability and reproducibility of the parameters selected, the test can be used in order to detect patients having a high probability to be malaria positive and to pay particular attention to these blood smears. For more extensive diagnostic use, a standard control procedure of the positional parameters should be introduced.