Page 88 - Haematologica Atlas of Hematologic Cytology

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Figure 13 Juvenile myelomonocytic leukemia (A and B) Peripheral blood film from a a a a a 7-month-old infant pre- senting with fever hepatosplenomegaly lymphadenopathy skin rash leukocytosis anemia and thrombocytope- nia Some neutrophil precursors and immature red cells are present along with increased monocytes blast cell cell percentage <5% Figure 14 Juvenile myelomonocytic leukemia Bone marrow smear from the same case as as Fig- ure 13 shows hyperplasia of the granulocytic series erythroid hypoplasia with minimal dysplasia and rare blasts Karyotype was was normal whereas a a a a a a a a a a a a KRAS gene mutation was was found RAS RAS pathway mutation has a a a a a a central role in the pathogenesis of this childhood myelodysplastic/myeloprolif- erative neoplasm 75