July 2022 (PDF for print)
Patient Demography: Female, 50 years old.
Diagnosis: Severe pancytopenia (anemia, thrombocytopenia, and leukopenia) caused by an acute myeloid leukemia.
Other Information: Asthenia and fever that were related to an acute pharyngitis.
Biochemical Test Results: C-reactive protein (CRP) 25 mg/dl; lactate dehydrogenase (LDH) 354 mg/dl.
Microscopic Review: Neutropenia and immature cells (myeloid blasts); immature granulocytes are present with a good correlation in percentage detected by the Yumizen H2500 analyzer. We observe anisopoikilocytosis (presence of erythrocytes of varying size and shape) related to the stress in the normal maturation of the cells in the bone marrow. Those are common morphological features observed in this clinical condition. 2% of nuclear red blood cells (NRBC) are detected without any abnormal morphological changes. In this type of case, monoblasts may interfere with monocyte count.
This clinical case has been provided by Anna Marull, Maite Serrando, Laboratori Clínic Territorial IAS-ICS Girona, Spain.
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