FBC Results       

WBC 147.22 * (10^3/mm3)

RBC 2.08 *(10^6/mm3)

HGB 6.6 *(g/dL)

HCT 19.2 *(%)

MCV 92 (fL)

MCH 31.7 (pg)

MCHC 34.4 (g/dL)                              

PLT 63 (10^3/mm3) 

Neutrophils 0.7%

Lymphocytes 2.1%

Blasts 96.5 %

Clinical Details

Emergency? AML

Slide Information

Anaemia.

Aniso-poikilocytoses (echinocytes++).

Neutropenia. Thrombocytopenia.

Hyperleucocytic blastosis.

Large blasts with often "bissac" nuclei.

Rarely granulated blasts (no Auer bodies seen).

Expert's comments:

AML M5a? NPM1 mutation? Check the platelet

count by manual method.

AML M5a Quick Overview

AML M5 (Acute monocytic/monoblastic leukaemia) is subclassified as either M5a or M5b depending upon the degree of monocytic maturation. M5a (Acute Monoblastic Leukaemia) is characterised by having >80% monoblasts of the monocytic element, whereas M5b (acute monocytic leukaemia) is where there is <80% monoblasts of the monocytic element. Monoblasts can be defined as large cells (20-30 um), with round/oval nuclear shape, prominent nucleolus, basophilic cytoplasm with some fine azurophilic granules. The nucleophosmin (NPM1) mutation is the most common genetic lesion in adult acute leukaemia (present in about 1/3rd of all cases). The presence of the NPM1 Mutation and the absence of the FLT3 ITD mutation has been shown to be a favourable prognostic indicator.

December Quiz Answers

1) What word describes changes in Red Blood Cell shape?

 Answer: Poikilocytosis

2) This cell can be either T or B.

Answer: Lymphocyte

3) Can you identify this white cell?

Answer: Eosinophil

4) What Red cell inclusion may be “happy”? 

Answer: Howel JOLLY body

5) What feature can be seen in this red cell?                      

Answer: Plasmodium Falciparum Trophozoite

6) Can you identify this cell?  

Answer - Hairy cell

7) What feature is seen in this film?

Answer - Rouleaux

8) Which of these features may be seen in Neutrophils during infection?

a) Neutrophil left shift

b) Excess Granulation (Neutro-Toxic Granulation)

c) Pappenheimer bodies

Answer: Neutrophil Left Shift, Excess Granulation (Neutro-Toxic Granulation)

9) What term is used for the red cells in the picture below?

Answer: acanthocytosis

10) What cell’s name is the same as Mistletoe berries?

a) Platelet

b) Red Cell

c) White cell



Answer: White cell