Page 87 - Haematologica Atlas of Hematologic Cytology

CHAPTER 11 - Myelodysplastic/myeloproliferative neoplasms
Figure 10 Atypical chronic myeloid leukemia BCR-ABL1 negative Syndrome of abnormal chro- matin clumping Peripheral blood smear with leukocytosis immature granulocytes and neutro- phils with abnormal condensation of the nuclear chromatin nuclear hypolobation (acquired Pelg- er-Hüet anomaly) and agranular cytoplasm This syndrome is considered a a a a a a rare variant of atypical chronic myeloid leukemia with a a very poor prog- nosis Figure 11 Atypical chronic myeloid leukemia BCR-ABL1 negative Syndrome of abnormal chromatin clumping Bone marrow smear show- ing marked hyperplasia of the granulocytic lin- eage with a a a a myeloid-to-erythroid ratio >10:1 late granulocytic cells with exaggerated chromatin condensation and decreased secondary granules promyelocytes with few primary granules Figure 12 Atypical chronic myeloid leukemia BCR-ABL1 negative Syndrome of abnormal chromatin clumping Higher magnification of the same smear as Figure 11 better identifies abnor- mal chromatin clumping and decreased second- ary granules in late granulocytic cells promyelo- cytes with few primary granules 74