Page 1 of 2 Flow Cytometry Report PHYSICIAN PATIENT Patient: SAMPLE PATIENT DOB/Sex: MR/Chart #: Specimen: BONE MARROW Collected: 3/27/2012 Received: 3/28/2012 SAMPLE DOCTOR Copies: REPORT DATE: 3/28/2012 SPECIMEN Accession #: All Specimens: 2 BM NA HEP, 1 BM EDTA 1. Increased Myeloid Cells 2. Mild Increase in Myeloblasts with an Abnormal Immunophenotype INTERPRETATION: Comment: These abnormalities can be seen in a variety of myeloid neoplasms, including myeloproliferative, myeloproliferative/myelodysplastic and myelodysplastic disorders. Correlation with the CBC/Diff data and examination of a stained bone marrow aspirate smear suggest that a myeloproliferative neoplasm is most likely in this case. CD34 positive blasts account for 2% of total white blood cells and have an aberrant myeloid immunophenotype. Blasts espress CD34, CD38, dim CD33, bright HLA-DR, dim CD11b, dim CD117, dim CD45, without expression of CD13, CD56, CD7, CD2, CD16, CD14, CD41, CD64 and CD61. The viability of the specimen is 82%. The granulocytes (88% of the total white blood cells) and monocytes (1% of the total white blood cells) reveal no significant immunophenotypic abnormalities. B-cells comprise 8% of the lymphocytes and have a kappa:lambda ratio of 1.03. Approximately 78% of lymphocytes are T-cells with a CD4:CD8 ratio of 1.14 (Normal 1-4). NK cells account for 1% of the total white blood cells (14% of lymphocytes). Plasma cells are not detected. FLOW CYTOMETRY DIFFERENTIAL (% of total cells) LYMPHOCYTES 4 B CELLS 4 Kappa:Lambda Ratio 1.03 T CELLS 38 CD4:CD8 Ratio 1.14 Large Granular Lymphs 5 NK CELLS 7 MONOCYTES 1 GRANULOCYTES 88 BLASTS 2 PLASMA CELLS Negative VIABILITY 82 ANTIBODIES ANALYZED: Antibodies used for evaluation include: CD2,3,4,5,7,8,10,11b,13,16,19,20,33,34,38,45,56,57,7AAD, HLADR, kappa, lambda,14,41,61,64,117 Leukocytosis, thrombocytosis. CLINICAL HISTORY: The immunohistochemical assays were developed and their performance characteristics determined by OncoMetrix. They have not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. This testing is used for clinical purposes. It should not be regarded as investigational or for research. This laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) as qualified to perform high complexity clinical testing. IDC9 Codes: 288.60, 238.71 CPT Codes: 88184; 88185x27; 88189 (877) 670-HEME (4363) Dr. Douglas W. Kingma, Laboratory Director OncoMetrix CLIA #: 44D0915029, TN License #: 0000003284 150 Collins Street, Memphis, TN 38812 Poplar Healthcare, PLLC Howard L. Martin, III, M.D., Medical Director BONE MARROW ASPIRATE: