Flow Cytometry Report

Page 1 of 2

PATIENT

Patient: SAMPLE PATIENT DOB/Sex: MR/Chart #: Accession #:

SPECIMEN

Specimen: 1 Sodium Heparin PB Collected: 6/19/2011 Received: 6/20/2011

All Specimens: 2 Sodium Heparin PB, 1 EDTA PB

PHYSICIAN

SAMPLE DOCTOR Copies: REPORT DATE: 6/20/2011

Clinical History: Hepatosplenomegaly, nonpathologically enlarged lymph hilar, peripancreatic lymph nodes, and leukocytosis with thrombocytopenia.

INTERPRETATION:

PERIPHERAL BLOOD, FLOW CYTOMETRIC ANALYSIS: CD5+ MONOCLONAL B- CELL POPULATION IDENTIFIED IN A REDUCED VIABILITY SPECIMEN.

Comment: Flow cytometric analysis identifies a lambda light chain restricted monoclonal B-cell population expressing CD19, intermediate to bright CD20, CD5, CD22 , intermediate to bright FMC7, without expression of CD10, CD11c, CD23, CD25 or CD103 and comprising 25% of total events. The presence of CD5 expression by this monoclonal B-cell population suggests a differential diagnosis including chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and mantle cell lymphoma. The expression of intermediate to bright CD20, lambda surface light chain, and FMC7 in the absence of CD23, favors mantle cell lymphoma. FISH studies are in progress and will be reported separately. Due to delayed receipt of this specimen, (three days old upon receipt), results should be interpreted with caution in this reduced viability specimen. FLOW CYTOMETRY DIFFERENTIAL:

FLOW CYTOMETRY DIFFERENTIAL (% of total cells)

LYMPHOCYTES B CELLS Kappa/Lambda Ratio T CELLS CD4/CD8 Ratio Large Granular Lymphs NK CELLS LYMPHOSUM MONOCYTES GRANULOCYTES BLASTS PLASMA CELLS % VIABILITY 55 67 0.00 19 1.15 12 30 116 5 32 0 Not Detect 45

ANTIBODIES ANALYZED: Antibodies used for evaluation include: CD2,3,4,5,7,8,10,11b,11c,13, 15,16,19,20,22,23,25,33,34,38,41,45,56, 57,79b,CD103, HLADR,FMC7 kappa,lambda,

OncoMetrix

150 Collins Street, Memphis, TN 38812

Dr. Douglas W. Kingma, Medical Director

(877) 670-HEME (4363)

CLIA #: 44D0915029, TN License #: 0000003254

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.

ICD9 Codes: 200.3

ONC014a - rev. 07/11

CPT Codes: 88184; 88185x27; 88189

Flow Cytometry Report

Page 2 of 2

PATIENT

Patient: SAMPLE PATIENT DOB/Sex: 7/14/1931 / M MR/Chart #: Accession #:

SPECIMEN

Specimen: 1 Sodium Heparin PB Collected: 6/19/2011 Received: 6/20/2011

All Specimens: 2 Sodium Heparin PB, 1 EDTA PB

PHYSICIAN

SAMPLE DOCTOR Copies: REPORT DATE: 6/20/2011

Peripheral Blood Differential

FMC7+ / CD23- B-cells

Lambda Monoclonal B-cells

Electronically signed on 6/20/2011 2:19 PM by Doug Kingma, M.D. Hematopathologist

OncoMetrix 150 Collins Street, Memphis, TN 38812 Dr. Douglas W. Kingma, Medical Director (877) 670-HEME (4363) CLIA #: 44D0915029, TN License #: 0000003254

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.

ICD9 Codes: 200.3

ONC014a - rev. 07/11

CPT Codes: 88184; 88185x27; 88189