In flow cytometry (FCM), gating is performed on CD45 × SS scattergrams for the analysis of hematopoietic tumors. In this study we report a case of diffuse large B-cell lymphoma (DLBCL) with bone marrow infiltration of CD20-positive and CD45-negative PTCL. Clinical course: At the time of initial diagnosis, the patient had been diagnosed with DLBCL and shown a complete response after chemotherapy Thereafter, pancytopenia progressed gradually and a bone marrow examination was performed. FCM of the scattergram showed a T-cell antigen-positive cell population (10.9%) in a CD45-negative area, with pan-T-cell antigen positivity partial CD10 positivity and partial CD7 negativity In addition, T-cell receptor p-chain gene rearrangement was observed. Thus, a diagnosis of PTCL bone marrow infiltration was made. Reanalysis of FCM results at the time of the initial diagnosis revealed a pan-T-cell-antigen-positive and CD20-positive cell population in a CD45-negative area, suggesting that the patient had DLBCL with PTCL at the time of initial diagnosis. Discussion: The 10-color FCM method was effective in detecting PTCL because it allowed us to evaluate the expression of 10 antigens on the same cell simultaneously It is important to carefully analyze all cell populations on scattergrams, regardless of the primary objective. [Review]
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