45 year male, came to the hospital with the complains of fever since one month, loss of appetite and weight loss to since 1 week. On palpation splenomegaly was found.. no lymph nodes enlarged. CBC revealed Hb- 3.9 gm/dl, TLC- 1.33 lakhs, platelets- 13000 cells .. these are the peripheral smear microscopic picture.. kindly give your views!!!!

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Acute leukaemia mostly myeloid or T cell ALL,to be confirmed with flow cytometry.

morphologically seems to be acute myeloid leukaemia M2 type,advised further study.

Smear shows.... Rbcs are normocytic to microcytic.... Moderate hypochromia.... Total count is increased... Cells are larger in size....with many cells showing prominent nucleoli... Blast cells are seen.... Mostly myeloid series cells.... Diagnosis..... Acute leukemia.... Most probably.... Myeloid type

How big is spleen?? Possibility of CML with blast crisis also needs to be considered. MPO staining of PS will help. Followed by flowcytometry on peripheral smear.

Smidge cells seen. CLL

leukemia

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