ambiguous lineage


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  • Assigning lineage

    • myeloid: MPO or monocytic
      • monocytic: 2 of NSE, CD11c, CD14, CD64, lysozyme
    • T: CD3
      • usually cytoplasmic, rarely surface
    • B: CD19, CD79a, CD22, CD10
      • CD19 plus 2 of the following: strong CD19, CD79a, cCD22, CD10
  • Acute undifferentiated leukemia

    • no lineage
    • often express CD34, HLADR, CD38
    • can be TdT+
  • multiple phenotype acute leukemia

    • biphenotypic: one blast population, 2 lineages
      • B/T ALL + MPO
      • B/T ALL + monoblastic
    • bilineal: two blast population, 2 lineages
      • population of less than 20% AML
      • plus separate population of something else
  • NK cell lymphoblastic leukemia

    • CD56
    • immature T markers: CD7, CD2, cCD3
    • lacks B and myeloid
    • rule out blastic plasmacytoid dendritic cell leukemia