The cells in this bone marrow are more differentiated than in the previous one, and, going by the Wright's stained preparation, you can suspect the leukemia to be monocytic. This represents FAB type M5b. Some of the cells have irregularly shaped nuclei. Most of them have a subtle, dull grayness to the cytoplasm. Some have budding of the cytoplasm, and several have chromatin creases. The cells gave the characteristic cytochemical staining reactions for monocytes. Note the bilobed nucleated erythroblast. "Megaloblastoid" and bizarre multinucleated erythoblasts are seen commonly in ANLL. Abnormal two- and four-lobed megakaryocytes and micromegakaryocytes also are frequently present in the bone marrow. These abnormalities of erythroblasts and megakaryocytes are reflected in the blood by the presence of giant platelets and abnormally shaped erythrocytes.
Course Section: 09. Acute Myelomonocytic Leukemia - Monocytic Leukemia - and Erythroleukemia
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