Canadian Association of Pathologists - Case of the Month, February 2007
67 year-old man with acute onset of fatigue.
Contributed by Dr. Douglas Tkachuk and Tanya Anderson, University Health Network, Toronto, Ontario (doug.tkachuk@uhn.on.ca). Scanning of 120x smear courtesy of Aperio Technologies, Inc. Virtual microscopy cases hosted by Objective Pathology Services Ltd., Toronto, Ontario.
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Clinical summary:
A 67 year-old man presented with acute onset of fatigue. Blood film revealed anemia and increased numbers of circulating "blasts". Bone marrow examination was performed for: morphological examination, histochemistry (myeloperoxidase and butyrate esterase stains), flow cytometry, molecular studies, and cytogenetics.
Microscopic description:
Wright Giemsa stained marrow aspirate smear (Aperio 120x scan)
Butyrate esterase stained marrow aspirate smear (Aperio 40x scan)
Myeloperoxidase stained marrow aspirate smear (Aperio 40x scan)
Other tests:
Flow cytometry results
Electron micrographs of the leukemic blasts taken from clot section
Molecular testing: RTPCR negative for bcr-abl transcripts.
Cytogenetics: normal karyotype, 46XY.
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