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Case 45 - Discussion

Hematopathology Case


Acute Myeloid Leukemia

  • I don't have flow cytometry and cytogenetic data for this case. The peripheral blood smear shows numerous blasts which are large in size, with irregular nuclei, fine chromatin, and occasional nucleoli. Blasts with bilobated nuclei, resembling "butterfly cells", are noted. The cytoplasm is moderate to abundant with rare Auer rods.

  • Overall, I favor acute myeloid leukemia based on the pure morphologic features. Flow cytometry and cytogenetic data are necessary for a further classification. Particularly, the hypogranular variant of acute promyelocytic leukemia has to be ruled out due to the severe thrombocytopenia and presence of bilobated cells.