#00063716

A female patient of 83 years with history of weakness, fever and bleeding was admitted to our service. Blood cell counts revealed anemia (hemoglobin, 10.18 g/dL), hyperleukocytosis (171.1x10⁹/L) and thrombocytopenia (28.x10⁹/L). Peripheral Blood smear showed 88% of cup-like blasts (May Grunwald-Giemsa stain, original magnification ×1000). An important morphological finding in acute myeloid leukemia blasts is prominent nuclear invagination called a cup-cuplike blast. The blasts are medium-sized and have moderate cytoplasm with few fine azurophilic granules. This morphology is associated with NPM1 mutation.