{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:51:03Z","timestamp":1791273063056,"version":"4.1.0"},"reference-count":9,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cytopathology"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Extramedullary blast proliferation (EBP) occurs in approximately 4%\u201316% of patients with chronic myeloid leukaemia (CML) in blast phase and may precede overt marrow blast transformation. Although myeloid lineage predominates, lymphoid blast crises account for approximately 20%\u201330% of cases, with T\u2010lineage differentiation representing only a small minority. Accurate recognition is important because EBP defines blast\u2010phase disease irrespective of the bone marrow blast percentage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>\n                      A 40\u2010year\u2010old man presented with generalized lymphadenopathy, hepatosplenomegaly, anaemia, and marked leukocytosis. Bone marrow examination demonstrated CML in chronic phase, while fluorescence in\u00a0situ hybridization confirmed\n                      <jats:italic>BCR<\/jats:italic>\n                      ::\n                      <jats:italic>ABL1<\/jats:italic>\n                      fusion. Fine needle aspiration cytology (FNAC) from a cervical lymph node revealed a monomorphic population of intermediate\u2010sized blasts with a high nuclear\u2010cytoplasmic ratio and scant agranular cytoplasm. Flow cytometric immunophenotyping performed on the aspirate demonstrated expression of cytoplasmic CD3, CD5, CD7, CD34, CD38, CD33, and CD117, with absence of myeloperoxidase, CD4, and CD8, establishing a diagnosis of extramedullary T\u2010lymphoblastic blast crisis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case highlights the value of FNAC combined with flow cytometry in diagnosing extramedullary blast proliferation. Awareness of this rare manifestation is essential because it may represent the first evidence of blast\u2010phase transformation despite chronic\u2010phase morphology on bone marrow examination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cyt.70126","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T04:24:46Z","timestamp":1788841486000},"page":"662-666","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extramedullary T\u2010Lymphoblastic Blast Crisis in Chronic Myeloid Leukaemia: A Unique Cytologic Diagnosis Confirmed by Flow Cytometry"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7368-0323","authenticated-orcid":false,"given":"Aravind","family":"Radhakrishnan","sequence":"first","affiliation":[{"name":"Department of Pathology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0791-9426","authenticated-orcid":false,"given":"Nabhajit","family":"Mallik","sequence":"additional","affiliation":[{"name":"Department of Hematology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1198-8491","authenticated-orcid":false,"given":"Pankaj","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Clinical Hematology and Medical Oncology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2159-4325","authenticated-orcid":false,"given":"Parikshaa","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Cytology and Gynecological Pathology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"146","article-title":"Extramedullary Disease in Ph'\u2010Positive Chronic Myelogenous Leukemia: Frequency, Clinical Features and Prognostic Significance","volume":"75","author":"Inverardi D.","year":"1990","journal-title":"Haematologica"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2126(96)00054-9"},{"key":"e_1_2_9_4_1","volume-title":"WHO Classification of Tumours: Hematolymphoid Tumors","author":"WHO Classification of Tumours Editorial Board","year":"2022"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lrr.2013.07.002"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1309\/GTGTEQAFMV30W753"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.25372"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24947"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2026.1784891"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11899-023-00709-4"}],"container-title":["Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cyt.70126","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cyt.70126","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cyt.70126","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:56:54Z","timestamp":1791269814000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cyt.70126"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":9,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1111\/cyt.70126"],"URL":"https:\/\/doi.org\/10.1111\/cyt.70126","archive":["Portico"],"relation":{},"ISSN":["0956-5507","1365-2303"],"issn-type":[{"value":"0956-5507","type":"print"},{"value":"1365-2303","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]},"assertion":[{"value":"2026-07-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}