Figure 1. The patient is a 70 year old male who was diagnosed with AML-M1 and underwent two standard induction therapies. He was then placed on Mylotarg as therapy for residual disease. His CBC at this time showed a hemoglobin of 10g/dL, WBC of 5k/uL with a normal differential and a platelet count of 446k/uL. A peripheral smear shows moderate anisocytosis and poikilocytosis. Microspherocytes, polychromatophilic and fragmented RBCs are present. Tear-drop RBCs can also be seen.
Figure 2. A low-powered view of the marrow aspirate is shown. Large groups of homogenous-appearing cells are noted. These cells have a high nuclear/cytoplasmic ratio. Normal hematopoietic elements are not identifiable.
Figure 3. At a higher magnification of one of these groups, the cells have a slightly basophilic cytoplasm, nuclei with a fine chromatin pattern and contain one or more large nucleoli. Cytoplasmic vacuolization is present in some of the cells.
Figure 4. In this group molding of the cells is more apparent. Prominent nucleoli are also evident. There is a suggestion of gland formation in the lower area of the cellular group.
Figure 5. The bone marrow biopsy is cellular and appears to have two distinct regions. There is a hypocellular area on the upper right; cellular elements interspersed among the fat cells are evident in the remainder of the biopsy.
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