Leukemia case (18)

Case study : - A46_years_old woman presented with diffuse bone pain she had a history of acute myeloid leukemia with minimal differentiation (AML-Mo) and normal karyotype diagnosed 15meutl after beginning induction chemotherapy and received 3 cycles of can solidation Chemotherapy until to months before her current presentation) the bone marrow was packed ( 95% cellularity ) with immature myeloid cells that stained positively for CD13 ,CD 33 , CD 41 ,CD 51 and factor VIII and negatively for myeloperoxidase ..

CBC : - 3.8*10^9/L WBC 10.2 g/dl Hb 67*10^3/L PLT 37 % Blasts

Peripheral Smear : -

Cytogenetic analysis revealed an abnormal female karyotype with 47,XX+1der (1:13) (4to:qto)A FL T3/TRD Mutated The aspirate shewed frequent Medium to large megakaryoblastic with-grey the basophilic cytoplasm high nucleus to cytoplasm ratio ,pseudo pool formation , and cytoplasmic projection resembling budding typical Plats .

Diagnosis :- A diagnosis at AML-Mo replace as acute megakaryoblastic leukemia ( AML-M7 ) was male . Although the patient has been receives reduction chemotherapy for the past 20 Month , she has not achieved CR yet . Cytoplasmic blebs and pseudopod formation are characteristic Morphologic feature of megakaryoblast in AML – M7 , which frequently appear in clusters mimicking metastatic Tumor..

Definition: Acute megakorgoblastic leukemia is one form of acute myelogenous leukemia. It is classified as M7 according to the FAB system. AMKL is defined as an AML with >20% Blasts, of which 50% or more are the megakaryocyte