Myeloblast with cup-like nuclear invagination 1

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Myeloblast with cup-like nuclear invagination 1

#00063006

Author: Mohammad Asees MSc hematology; Professional Lab- Palestine
Category: Myeloid Neoplasms and acute leukemia (WHO 2016)
Published Date: 05/01/2020

At Professional Labs/Palestine
A 69 years old male with marked Leukocytosis (200*10^9/L); anaemia (Hb=8g/dl) and Thrombocytopenia (plt=50*10^9/L).
➡️Blood Film shows:
⏺️RBC MORPHOLOGY
Normocytic normochromiccells, mild polychromasia, and occasional nRBC.
⏺️WBC MORPHOLOGY
Marked leucocytosis, Blasts comprised the majority (approximately 85%) of circulating peripheral blood. The blasts are large with high N:C ratio and prominent nucleoli and has fine chromatin, some blasts show fish mouth nucleus (Cup like). Auer rods not seen.
⏺️PLATELET MORPHOLOGY
Marked thrombocytopenia with normal morphology.

🔴PROVISIONAL DIAGNOSIS
Based on clinical presentations, CBC result, and morphology, this case is highly suggestive of acute myeloid leukaemia (acute myeloid leukemia with recurrent genetic abnormalities, mainly NPM1 and FLT3 mutation ) and further tests are suggested.

🔴RECOMMENDATION:
Bone marrow aspirat and biopsy
MIFC and molecular studie

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