Blast Cells and Pancytopenia in a Child's Blood Smear

Clinical case of pancytopenia and splenomegaly in a child. Morphology of cells in a peripheral blood smear, differential diagnosis of blasts and leukemia.

Евгения Тенякова 1 min February 19, 2022

Hematology analyzer printout: pancytopenia (WBC 2.5, HGB 56, PLT 50)

Peripheral blood smear: atypical mononucleated cell with high nuclear-cytoplasmic ratio

Peripheral blood smear: suspicious mononucleated cell (possible blast)

Peripheral blood smear: single atypical cell against a background of erythrocyte echinocytosis

Peripheral blood smear: two atypical cells with signs of blast transformation

Blood smear: round immature cell with a narrow rim of cytoplasm on microscopy

Good day, colleagues! Please help a novice doctor. A child was admitted with abdominal pain and an enlarged spleen. COVID-19 was detected. The condition is worsening, they have been combining treatments and transfusing. The smear shows such cells… and even then, they were hard to find; there are also normal lymphocytes and segmented neutrophils. What do you think this is?