Peripheral blood smear
The peripheral blood smear shows circulating blasts (solid arrow head) and atypical plasmacytoid mononuclear cells (open arrow head) with variably immature chromatin and moderate pale blue cytoplasm.
Bone Marrow Aspirate at low power
Wright -Giemsa stained bone marrow aspirate at low magnification shows increased blasts (arrow) against a background of trilineage haematopoiesis.
Bone Marrow Aspirate at high power
Wright-Giemsa stained Bone marrow aspirate at high magnification shows increased blasts (solid arrow-head) and atypical plasmacytoid mononuclear cells with immature chromatin and moderate to abundant pale blue cytoplasm (open arrow head).
Bone marrow biopsy
The bone marrow biopsy is hypercellular for age (~ 90% cellularity) with increased blasts against a background of trilineage hematopoiesis.
Marrow Biopsy Immunohistochemistry
The blasts are positive for CD34, CD123 and negative for TCL1.