I
did the digital morphology exercise today – I spotted blast cells with nucleoli
and Auer rods even though the Wbc was not especially high. There were giant
platelets, but the platelet count was reduced. TO confuse the issue there were
even nucleated red cells and spherocytes.
I
felt this was a case of AML… I was right: “this
is acute promyelocytic leukaemia. Although morphology can be highly variable in
the condition the large blast cells already shown with complex nuclei and accompanying
coagulopathy should suggest the diagnosis. Key is to find the typical highly
granular cells, and the presence of multiple Auer rods should confirm APL as
the diagnosis (subject to confirmation). It is very important to be aware of
the diagnosis since early treatment can be life-saving”.
I’m
happy with my findings…
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