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Autor*: A. Buliková
Description:
77-years old woman with history bruising, fatigue and fevers for a month. Cell blood count shows moderate leukocytosis (57 G/l), low platelet count (38 G/l) and mild anemia (Hb 116 g/l). Peripheral blood smear discovers monoblast and promonocytes. Bone marrow smears morphology shows acute monoblastic leukemia with 86,2% monoblasts.
Zařazení*:
Acute monoblastic and monocytic leukaemia
Přílohy*:
Description: Six blasts with weakly to strong basophilic rather voluminous cytoplasm. Rest of the cells are promonocytes, destroyed cells, naked nuclei and one plasma cell (at 3 o'clock). 
Description: Hyper-cellular bone marrow which contains 86,2% monoblasts (>80% of all nucleated cell of bone marrow are of monocytic lineage; > 80% of monocytic lineage are monoblasts). Hemophagocytosis - erythrophagocytosis can be observed (monoblast at right from the middle; in this patient cytogenetic analysis to prove association with t(8;16) has not done ). 
Description: The great majority of non-destroyed cells are monoblasts. Their shape varies from round to oval, cytoplasm is abundant, it may contain fine granules and numerous vacuoles. Some of the cells are more mature promonocytes (at 9 o'clock) and monocytes (at 3 o'clock). 
Description: The monoblast and promonocytes show intense non-specific esterase activity. 
Description: The staining of non-specific esterase (alpha naphthyl acetate esterase ) - strong positivity is blockated by natrium fluoride in immature cells of monocytic lineage (compare with previous picture).