This is the peripheral blood from another patient with ALL. You can see that the appearance of the lymphoblasts is somewhat different from that observed in the previous two slides. The blasts are larger, generally two times or more the size of normal small lymphocytes, and they vary considerably in size. The nuclei also vary considerably in shape and size, and the nuclear chromatin ranges from a fairly mature, clumped configuration to a very fine pattern. A few notable nucleoli are present in some of the blasts. In this case, most of the blasts have fairly generous amounts of cytoplasm, although Auer rods are not seen, of course. Cytoplasmic vacuolation and granularity are not marked but may be present. This is an example of the type of ALL seen in adults, although ALL is considerably less common than ANLL in this age group.
Course Section: 07. Lymphocytic Leukemia: Acute and Chronic
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