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CNS Acute Myeloid Leukemia

View larger version (166K): [in this window] [in a new window]   Figure 1. 63 year old male presented with to Emergency Room with history of weakness and inability to walk. Of note was a past history of chronic thrombocytopenia and leucopenia. His WBC on admission was 227,000/uL with 97% of the cells reported as blasts. He received emergency leukophoresis and was then stated on hydroxyurea and allopurinol. A spinal tap was performed. The WBC cell count on the fluid was 197/uL with 99% of the cells being interpreted as blasts. The image shown is of a cytospin preparation of the cerebrospinal fluid. At a low power view there appears to be a homogeneous population of intermediate to large cells with basophilic cytoplasm and a high nuclear/cytoplasmic ratio.

View larger version (101K): [in this window] [in a new window]   Figure 2. At a higher magnification, the cells can be noted to have deeply basophilic cytoplasm, many containing multiple azurophilic granules but no distinct Auer rods, irregular nuclear borders, fine chromatin and large single to multiple nucleoli.

View larger version (75K): [in this window] [in a new window]   Figure 3. The morphologic features of the blasts are more apparent in this view. Several of the blasts have a fissured nucleus.

View larger version (83K): [in this window] [in a new window]   Figure 4. The morphologic heterogeneity is again evident in this view. Note that the cells are non-adherent. Many of the cells contain multiple nucleoli or single large nucleoli.

View larger version (120K): [in this window] [in a new window]   Figure 5. A high power view is shown. Azurophilic granularity can be seen in essentially all of the blasts. Variability in nuclear size and contour is readily noted. Immunophenotypically these cells marked as CD34, CD33, and CD13 positive. The karyotype of the blasts was 49,XY,+8,+9,+11 and +13. These finding were consistent with a diagnosis AML-M1 with precedent myelodysplasia.

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This Article Figures Only Services Similar articles in this journal Alert me to new content in the Image Bank Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lazarchick, J. Search for Related Content PubMed Articles by Lazarchick, J. Related Collections Acute Myeloid Leukemia Related ASH-SAP Chapter Related Image Bank Image Sets Related ASH Education Book Articles Social Bookmarking                   What's this?