A child with an early-B type ALL "in remission" showed the above VCS pattern on routine check up.
All results were normal except for a "variant lymphocytes" flag and subsequent morphological examination confirmed a number of atypical, although not overtly malignant, cells.
This child's original ALL phenotype showed an aberrant T cell associated marker CD5(weak) in addition to CD19 and CD10.
Shown below is a histogram from 3 colour analysis of the peripheral blood, gated on the CD19 positive population, clearly showing a small population of cells of the diagnostic phenotype.
Subsequent bone marrow examination and immunphenotypic analysis confirmed a relapse.