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Oncohematology

Acute Lymphoblastic Leukemia: Bone Marrow, Blood, and Effusions

A clinical case of acute lymphoblastic leukemia in a 9-year-old child: blasts in blood, bone marrow, pleural and pericardial effusions, PAS reaction.

Irina Kumskova Irina Kumskova 1 min
Peripheral blood smear, lymphoblasts with high nuclear-cytoplasmic ratio
Peripheral blood smear, lymphoblasts with high nuclear-cytoplasmic ratio
Bone marrow smear, total infiltration by blast cells (69% blasts)
Bone marrow smear, total infiltration by blast cells (69% blasts)
Cytological preparation of pericardial effusion, predominance of lymphoblasts
Cytological preparation of pericardial effusion, predominance of lymphoblasts
Smear of pleural effusion sediment with massive accumulation of blast cells
Smear of pleural effusion sediment with massive accumulation of blast cells
Cytochemical study, positive granular PAS reaction in blasts
Cytochemical study, positive granular PAS reaction in blasts
Fuchs-Rosenthal counting chamber, counting cytosis of effusion fluid (68,000 cells/µL)
Fuchs-Rosenthal counting chamber, counting cytosis of effusion fluid (68,000 cells/µL)
Complete blood count form, leukocytosis 35.6×10⁹/L and 65% blasts
Complete blood count form, leukocytosis 35.6×10⁹/L and 65% blasts
Blood biochemistry analysis form, increased LDH to 695.1 U/L and uric acid
Blood biochemistry analysis form, increased LDH to 695.1 U/L and uric acid
Coagulogram results, prolonged prothrombin time and elevated D-dimer
Coagulogram results, prolonged prothrombin time and elevated D-dimer

A 9-year-old child. Preliminary diagnosis: Acute lymphoblastic leukemia. 1 photo - peripheral blood 2 photo - bone marrow (blasts 69%) 3 photo - pericardial effusion 4 photo - pleural effusion 5 photo - positive PAS reaction in blasts 6 photo - cytosis (pericardial/pleural) in the chamber (68000-70000 cells/µL). In photos 3 and 4 - an abundance of lymphoid elements of varying maturity with a predominance of blast forms.

🙏 The publication was kindly provided by Clinical Laboratory Diagnostics Doctor Irina Kumskova, Amur Oblast, Blagoveshchensk, Children’s Regional Clinical Hospital.

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