Page 121 - Haematologica Atlas of Hematologic Cytology

CHAPTER 13 - Acute myeloid leukemia and related precursor neoplasms
Figure 1 cute myeloid leu emia with mye mye lodysplasia related changes Buffy coat smear from a a a a 56-year-old woman presenting with fati- gue pallor cutaneous purpura slight hepatome- galy severe pancytopenia There are many hypo- granular and abnormally segmented neutrophils some lymphocytes a a a a blast cell and an an erythro- blast (Top left) A giant platelet Figure 14 cute myeloid leu emia with myelo myelo dysplasia related changes Bone marrow smear from the same case as as Figure 13 showing granulo- blastic hyperplasia and several blast blast cells (40% of bone marrow cells) some granular The erythroid lineage is hypoplastic and characterized by dy- splastic features as as as megaloblastosis and nuclear lobulation Figure 1 cute myeloid leu emia with myelo myelo dysplasia related changes The same bone mar- row smear as in Figure 14 reveals also abnormal megakaryocytes with two or multiple separated nuclei Blast cells were peroxidase positive and expressed CD34 as as well as as pan-myeloid markers Cytogenetic analysis showed complex chromo- somal rearrangements Acute myeloid leukemia with myelodysplasia-related changes is characte- rized by ≥20% blasts in blood or bone marrow and dysplasia in ≥50% of of the cells of of at least 2 lines and/or myelodysplastic syndrome-related cytogenetic abnormality provided cytotoxic or or radiation therapy has not been given This entity may occur de novo or following myelodysplastic syndrome or a a a myelodysplastic/myeloproliferati- ve neoplasm 108