Hematology Case 57

Presented By Dr Mohammad Moharram

Released on 30-11-2021

Patient Data

30 years old female.

Clinical Data

Presented with fever.

Weight loss in the last month.

History of blood transfusion (2 units before 2 weeks)

Lymphadenopathy

Related Laboratory Results

  • CBC:

- WBC: 10.4x103 /uL (Analyzer differential count: Neutrophils: 0.8x103 /uL - Lymphocytes: 6.7x103 /uL - Monocytes: 2.8x103 /uL - Eosinophils: 0.1x103 /uL - Basophils: 0x103 /uL).

- HGB: 10.7g/dL - MCV: 95fL -MCH: 32pG - MCHC: 34%

- Platelet: 69x103 /uL

  • Peripheral blood smear : see below.

  • ESR: 124 mm/Hr

  • Normal RFT & LFT

  • Serum Iron: 34 umol/L (5-30.5)

Case Picture(s) / Photo(s)

Images Comment / Findings

Peripheral blood smear:

Differential cell count showed blast cells: 41% mostly of myeloblasts (Most of them are medium sized cells with high nuclear cytoplasmic ratio. Basophilic cytoplasm. Nucleus show open chromatin with 1-2 visible nucleoli)

Immunophenotyping Report (done in outside facility)

Leukemia / Lymphoma panel

A population of cells which are morphologically and cytochemically correspond to blast cells with CD45 dim expression, gating shows blasts representin ~ 40% out of total peripheral blood cells.

The population are:

  • Positive for: CD34, CD38, CD13, CD117, CD33, HLA-DR & MPO

  • Negative for: CD19, CD2, CD7, CD20, CD64, CD11b, CD22, CD14, CD15 & cyCD3

Final Diagnosis

A case of acute myeloid leukemia. Cytogenetic workup is recommended for further classification.