Hematology Images

Peripherial Blood Smear of a patient with untreated Acute Myelomonocytic Leukemia
FAB Classification: AML-M4
This picture is from the blood smear of a patient with untreated acute myelomonocytic leukemia (M-4).
Case history

Untreated acute myelomonocytic leukemia (M-4) The white cell at left center is a late neutrophil with a very dense nuclear chromatin and unsegmented nuclear shape. The asynchronous nuclear cytoplasmic maturation indicates it is abnormal. A mature monocyte lies to its right. The cell at the lower edge is immature as evidenced by the high nuclear/cytoplasm ratio, blue cytoplasm, evenly distributed chromatin and a nucleolus. The nuclear cleft or fold suggests its monocytic nature. The cell near the right edge is a polychromatic stage nucleated red cell. In the upper left quadrant are two abnormally large megathrombocytes; one is almost void of any granules, the upper one contains many granules and peripheral vacuoles.

(Source: Bloodline The Online Hematology Resource)
Image used with permission from BloodLine - The Online Hematology Resource (www.bloodline.net), copyright 1998 Carden Jennings Publishing Co., Ltd. Image provided by Jean Shafer, MA, of Rochester University School of Medicine

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Peripherial Blood Smear of a patient with Acute Progranulocytic Leukemia
Hypergranular variety
FAB Classification: AML-M3
Case history

Acute progranulocytic (M-3) leukemia our of the five white cells contain multiple coarse red-purple granules, which appear to be primary granules developed in the PROMYELOCYTE (PRO GRANULOCYTE) stage. The nuclear cytoplasm ratio, shape of nucleus, and chromatin pattern are consistent with the promyelocyte-myelocyte stage. The call at lower right contains few granules and a nucleus that could be monocytic or myelocytic. Platelets are markedly reduced. This blood smear picture is from a patient presenting with acute promyelocytic (M-3) leukemia, hypergranular in type. This bone marrow smear was stained with the myeloperoxidase stain and then counterstained with Wright-Giemsa to demonstrate the cell outline and nucleus.

(Source: Bloodline The Online Hematology Resource)
Image used with permission from BloodLine - The Online Hematology Resource (www.bloodline.net), copyright 1998 Carden Jennings Publishing Co., Ltd. Image provided by Jean Shafer, MA, of Rochester University School of Medicine

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