29/Female C/o Fever & weakness. PS - Dimorphic anemia. Leukopenia with shift to left. Thrombocytopenia.

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Subleukemic leukemia. Blasts are noted. Nuclei are twisted, cleaved. DD : * AML - M3 Hypogranular variant. * Lymphoma Spill over to blood - T cell type. Advised BMA,BMB & Flow Cytometry.

- Blast cells ( mono / binucleated and agranular cells) D/D 1. ALL 2.AML M3 However,detail clinical history with organomegaly ,BM Study, flow cytometry for needful.

Binucleated cells and blasts, Advised peripheral blood flow cytometry DD: 1.AML M3 hypogranular variant ALL - Advised Bone marrow workup

Blasts. Sug.clinical correlation Bone marrow study Immunocytochemistry Flowcytometry Special stains

aleukaemic leukaemia possibility suggested. Bone marrow aspiration suggested.

Leukemia Adv - bone marrow aspiration & biopsy

AML M3. B.M N flow.ctometery. sugg.

Blasts ? ALL Adv- Bone marrow study

Looks like Leukaemia Please do bone marrow

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