A 63-year-old man presents with fatigue and frequent nosebleeds developing gradually over 4 months. He notes that he feels an abdominal fullness and becomes full easily when eating. On physical examination, he is afebrile but shows pallor of the conjunctivae and some dried blood around the nares. Splenomegaly is present, but the liver is not appreciably enlarged. The skin shows no rashes. Laboratory studies show a WBC count of 56,000/mm3(with 59% neutrophils), a hemoglobin of 8.5 g/dL, and a platelet count of 21,000/mm3. ECG shows normal sinus rhythm with no ST-segment changes. A peripheral blood smear is shown in the image. The cells stain positively with myeloperoxidase. What is the likely diagnosis?

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AML -m2. M3 will have convoluted nuclei

1. Most likely AML M2 2. AML M3 hypogranular. Advice cytogenetic analysis for confirmation.

AML- presence of auer rods in myeloblast. Also, myeloid series cells are MPO +ve.

AML, mostly M2

Why not M3?
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Myeloid. Leukemia

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