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. 2016 Feb 2;32(4):753–757. doi: 10.3904/kjim.2015.115

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Copyright © 2017 The Korean Association of Internal Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Figure 3. — Recurrent acute lymphoblastic leukemia (ALL) in the heart. (A) Ventricular biopsy showing diffuse infiltration of monotonous small cells in the myocardium and pericardium (H&E, ×40). (B) Lymphocytes showing infiltration and encroachment on cardiomyocytes. The atypical lymphocytes are medium-sized with round to oval nuclei showing vesicular chromatin and inconspicuous nucleoli, and have a scanty cytoplasm (high nuclear/cytoplasmic ratio; H&E, ×400). (C) Lymphocyte membranes expressing the pan-B-cell marker CD22 (×400). (D) Presence of terminal deoxynucleotidyl transferase in the nuclei of lymphocytes indicating their lymphoblastic nature (×400).