Figure 4
Myeloid sarcoma expressing cytoplasmic NPM1 and flow cytometric detection of cytoplasmic nucleophosmin in AML. (A) Multiple skin lesions; the arrow indicates the largest lesion. (B) Leukemic cells infiltrating the derma show aberrant cytoplasmic expression of NPM (arrow); the cells of epidermis (e) exhibit the expected nucleus-restricted positivity for NPM. (C) Leukemic cells express the histiocyte-restricted form of CD68 (monoclonal antibody PG-M1). (D) Leukemic cells are CD34−; the arrow indicates a CD34+ vessel that serves as internal control. (B-D) Alkaline phosphatase antialkaline phosphatase technique; hematoxylin counterstaining; images were collected using an Olympus B61 microscope and a UPlan FI 100×/1.3 NA oil objective; Camedia 4040, Dp_soft Version 3.2; and Adobe Photoshop 7.0. (E) Flow cytometry analysis of cytoplasmic nucleophosmin in AML. NPM1-mutated AML M5b 48% blasts showing the phenotype: CD34−CD13+CD33+CD117+MPO− CD56+NPMc+. (F) AML M1 with wild-type NPM1 gene and 93% blasts with phenotype: CD34+ CD13+ CD33+ CD117+ MPO+CD56+NPMc− (bottom left and right; courtesy of Prof Christian Thiede and Dr U. Oelschlaegel, University of Dresden, Dresden, Germany).

Myeloid sarcoma expressing cytoplasmic NPM1 and flow cytometric detection of cytoplasmic nucleophosmin in AML. (A) Multiple skin lesions; the arrow indicates the largest lesion. (B) Leukemic cells infiltrating the derma show aberrant cytoplasmic expression of NPM (arrow); the cells of epidermis (e) exhibit the expected nucleus-restricted positivity for NPM. (C) Leukemic cells express the histiocyte-restricted form of CD68 (monoclonal antibody PG-M1). (D) Leukemic cells are CD34; the arrow indicates a CD34+ vessel that serves as internal control. (B-D) Alkaline phosphatase antialkaline phosphatase technique; hematoxylin counterstaining; images were collected using an Olympus B61 microscope and a UPlan FI 100×/1.3 NA oil objective; Camedia 4040, Dp_soft Version 3.2; and Adobe Photoshop 7.0. (E) Flow cytometry analysis of cytoplasmic nucleophosmin in AML. NPM1-mutated AML M5b 48% blasts showing the phenotype: CD34CD13+CD33+CD117+MPO CD56+NPMc+. (F) AML M1 with wild-type NPM1 gene and 93% blasts with phenotype: CD34+ CD13+ CD33+ CD117+ MPO+CD56+NPMc (bottom left and right; courtesy of Prof Christian Thiede and Dr U. Oelschlaegel, University of Dresden, Dresden, Germany).

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