Page 127 - Haematologica Atlas of Hematologic Cytology

CHAPTER 13 - Acute myeloid leukemia and related precursor neoplasms
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Figure cute monoblas c c c c c c c leu leu emia (A) Bone marrow smear Most blasts are large and and have round or or or irregu- larly shaped nucleus nely dispersed chroma n n n n n n n n n n n n n n n one one or or or or more nucleoli and and abundant basophilic cytoplasm with ne ne ne ne azurophilic granules (B) Peripheral blood lm from the same case case More mature monocy c c c c c c c c c c c c cells are observed (C) Cerebrospinal uid cytospin showing many monoblasts in in in in in in in in a a a a a a a a a a a a a a a a a a a a a a case case with with meningeal involvement (D) Bone marrow smear Monoblasts with with nely cross-linked chroma n n n n n n n n n n n n n n n n n n n n n n n n n voluminous nucleoli deep basophilia and and vacuoliza on on on on on of the cyto- plasm (E) Bone Bone marrow marrow smear In this case case blast blast blast cells are are morphologically undi eren ated Only cytochemical and and immunological studies can demonstrate that that they are are of of monocyte lineage (F) Bone Bone marrow marrow blasts from the the the same case case express the the the an an an gen CD14 that that is is characteris c c c c c c c c c c c c c c c c c c c c of of monocy monocy monocy c c c c c c c c c c c c c c c c c c c c di di eren a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a on on on on on on on on on (immuno-alkaline phosphatase technique) Acute monoblas monoblas c c c c c c c c c c c c c c c c c c c c c c c leukemia leukemia leukemia (FAB (FAB classi classi ca ca on on on on on on on on on M5a) and acute acute monocy monocy monocy monocy c c c c c c c c c c c c c c c c c c c c c c c leukemia leukemia leukemia (FAB (FAB classi classi ca ca on on on on on on on on on M5b) are are acute acute myeloid leukemias in in in in which ≥80% ≥80% of of of the the the leukemic cells cells are are are of of of monocy monocy monocy monocy monocy c c c c c c c c c c c c c c c c c c c c c c c c lineage including monoblasts promonocytes and monocytes monocytes monocytes monocytes the the the the neutrophil component is <20% In acute acute monoblas monoblas monoblas c c c c c c c c c c c c c c c c c c c c c c leukemia leukemia leukemia ≥80% ≥80% of of of of the the the the monocy monocy monocy monocy monocy monocy monocy monocy c c c c c c c c c c c c c c c c c c c c c c cells cells cells are are are monoblasts whereas in acute acute monocy monocy monocy monocy monocy monocy c c c c c c c c c c c c c c c leukemia leukemia most of of the the the monocy monocy monocy monocy monocy monocy c c c c c c c c c c c c c c c cells cells are promonocytes or monocytes monocytes monocytes 114