🔬 Clinical case: acute myelomonocytic leukemia with normal karyotype
👨⚕ Male, 51 years old: Complaints — weakness, anorexia, temperature 37.8–39 °C. Initial diagnosis — ARVI, no effect from therapy. Later — bleeding gums, leukocytosis, enlarged cervical lymph nodes.
CBC upon admission:
- Leukocytes — 50.61 × 10⁹/L
- Hemoglobin — 121 g/L
- Platelets — 37 × 10⁹/L
- Blasts — 31%
- Promonocytes — 17%
- Monocytes — 9%
- Left shift
Myelogram:
- Total blasts and promonocytes — 47%
- Granulocytes — 29%
- Monocytic lineage — 27.2%
- Erythroid — 6%
- Lymphoids — 3.6%
- Plasmocytes — 2.6%
Cytochemistry:
- Lipids + in 35% of blasts and promonocytes
- PAS + in 42%
Immunophenotype (IPT): CD45low+, HLA-DR+, CD38+, cytMPO+, CD33+, CD13+, CD64+, CD14+, CD117+, CD15+; CD34-, cytCD34-, cytCD79a-, CD4-
Cytogenetics: Normal karyotype.
Diagnosis: Acute myelomonocytic leukemia (AMML). Induction therapy was performed, the patient is preparing for bone marrow transplantation.
🦴 In the photo — bone marrow: 🔴 Red arrows — blasts 🔵 Blue arrows — promonocytes
🙏 The clinical case was kindly provided by KLD doctor Yulia Kaliberda, Yekaterinburg.
Professional discussion is welcome in the comments.
