This is a 45 yo female with fever & weakness for 3 months, splenomagaly - 2 cm, mild sternal tenderness.

Lab. Findings:
Hb: 7.5 gm%
WBC: 1,400/mm3
Platelets: 1'200,000/mm3

B.Marrow: Hypocellular in all 3 cell lines, infiltration by highly abnormal immature cells constituting 80% of BM cellularity.

The following images from bone marrow aspirate smears are presented (all are oil 1000X):
1) Giemsa. Four blasts with cytoplasmic vacuolization,One of these at the bottom in mitosis. Also one normoblast.
2) Giemsa. Ten blasts with highly atypical morphology and again cytoplasmic prominent vacuolization.
3) PAS. Two blasts at the center having PAS positivity (red stained rods).
4) MPO. All the blasts are peroxidase negative but showing distinct prominent nucleoli.

Send comments to Dr. G.D.Mody (Haematopathologist) at   gdmody@eth.net