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Case 220 - Discussion

Hematopathology Case


B-Cell Acute Lymphoblastic Leukemia

  • The lymphoblasts in peripheral blood may show variable morphologic features, which can resemble myeloblasts or mature lymphocytes;

  • Compared to typical myeloblasts, the lymphoblasts are usually smaller in size and have a higher N/C ratio. The cytoplasm is mostly scant and agranular. There are no other stages of myeloid cells, as seen in some AML cases. The Background neutrophils typically show no dysplasia, as seen in some myelodysplasia-related AML case;

  • Mature lymphocytes should have more condensed chromatin and more abundant cytoplasm. However, mantle cell leukemia with blastoid features may mimic lymphoblasts.