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A 7 month infant presented with fever and breathlessness with raised total counts. Examination revealed 90 % blasts with prominent nucleoli. Flow cytometry revealed a tight cluster in the monocytic region. The blasts showed homogenous bright CD 33/4/64/HLA D with heterogeneous expression of CD14/15/11c. Blasts were negative for CD13/MPO/Cytoplasmic CD3/19/7/34/117/5/22/TdT/CD 61/41. FISH revealed MLL gene rearrangements in the blasts. No evidence of Down’s syndrome on cytogenetic studies was noted. Diagnosis of Infantile acute monoblastic leukemia was made. These leukemias are rare in infants and are associated with a poor outcome.

Blastic plasmacytoid dendritic cell neoplasm is a recently classified aggressive hematodermic neoplasm derived from plasmacytoid dendritic cells. We describe two cases of this neoplasm, one a 15 year old child and other a 65 year male. The diagnosis was made by evaluating the detailed clinical history, morphology and flow cytometric findings. The diagnosis is rendered difficult owing to common morphological and flow cytometric overlaps. The neoplasms were characterized by skin and soft tissue involvement and strong CD4/CD56 positivity. These neoplasms are highly aggressive and have many diagnostic overlaps. Strong suspicion and detection will help in early therapeutic interventions.