Cell Case #18

This Cell Case presents a 45 year old male. He was admitted to the emergency ward with dizziness and dyspnoe d’effort.


Result from the cellcounter:

Hb-level 5,8 g/dL, leukocyte count 70 x109/L and a platelet count of 11 x109/L, LDH was elevated 700 (<250 E/L) and the PT was prolonged (20sec; <11sec) with a normal APTT and fibrinogen.

Do you know the diagnosis? Please post your comments, thoughts and suggestions!

/ The CellaVision Blog Team

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This blog is created by CellaVision for laboratory professionals with a particular interest in hematology and digital cell morphology. Our aim is to inform, educate and inspire in equal measures – by highlighting interesting articles, sharing interesting patient cases and cell images, and presenting inspiring success stories from our community of CellaVision-users from around the world.

31 thoughts on “Cell Case #18”

  1. Nuclear morphology suggestive of APML (hypogranular variant) – note high white count suggests should start prednisolone to prevent differentiation syndrome, along with ATRA of course as soon as possible.

  2. Auer rods present, a distinctive feature of AML. WHO classification requires more than 20% blasts in the peripheral blood to make a diagnosis of AML. Order flow cytometry and cytogenetics to identify subtype.

  3. Acute Promyelocytic leukaemia. AML M3 Bilobed nuclei prominent, One of the photos demonstrates auer rods. Commonly known as faggot cells.

  4. Welcome back cellavision blog! looks like a case of French APML, with the bi lobed nuclei. Unfortunately the images no longer enlarge upon clicking so i can’t really see if they are of hypogranular variety.

    1. Yes, agree it would be useful if the individual images enlarged when clicked on. I can see enough microgranular activity to go with APML.

  5. The film shows appearance of Sezary syndrome. The cells show groved nuclear chromatin with a high nuclear/cytoplasmic ratio.. The nucleus are clefted in appearance.

  6. AML (FAB M3). Micro granular variant with t(15;17). The majority of the cells are agranular or poorly granular. The nuclei are irregular and occasionally bilobed with abundant cytoplasm mimicking monocytes. Rare cells have Auer rods.

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