Page 84 - Haematologica Atlas of Hematologic Cytology

Figure 3 Chronic myelomonocytic leukemia (CMML) Bone marrow (BM) smear with high cellu- larity and and increased number of of monocytes and and their precursors The sum of of blasts plus the the pro- monocytes is is is 18% allowing a a a a diagnosis of CMML CMML CMML type 2 2 (CMML-2) Instead CMML-1 is is is defined by the the the presence of 5-9% blasts blasts in in the the the BM and/or 2-4% blasts blasts in in the the the peripheral blood AB Figure 4 Chronic myelomonocytic leukemia Bone marrow smear (A) -naphtyl-acetate esterase stain is useful for identifying atypical monocytic cells showing intense cytoplasmic reactivity (B) Double esterase reaction demonstrates a a a a a a a a a a mixture of monocytic -napthyl-acetate esterase positive (black) and granulocytic chloro-ace- tate esterase positive (red) cells 71