case_images: PMC10874130_01
case_images: Bone marrow aspirate. The bone marrow aspirate shows small to medium-sized blasts (black arrow) with open chromatin, high nuclear-to-cytoplasmic ratio, and scant cytoplasm. No granules or Auer rods are seen.
case_images: cureus-0016-00000052489-i01.jpg
case_images: PMC10874130_01_cureus-0016-00000052489-i01.jpg
case_images: FIG1
case_images: A bone marrow aspirate and biopsy were performed, which confirmed precursor B-cell acute lymphoblastic leukemia (Pre-B ALL), comprising 71% blasts (Figures 1-2).
case_images: Bone marrow trephine . The bone marrow trephine shows that 90% of the bone marrow is infiltrated by blast cells (black arrow).
case_images: cureus-0016-00000052489-i02.jpg
case_images: PMC10874130_01_cureus-0016-00000052489-i02.jpg
case_images: FIG2
case_images: A bone marrow aspirate and biopsy were performed, which confirmed precursor B-cell acute lymphoblastic leukemia (Pre-B ALL), comprising 71% blasts (Figures 1-2).
case_images: Acute leukemia immunophenotyping by flow cytometry. A: CD45 dim positive, B: CD14 and CD64 negative, C: CD19 and CD10 positive, D: CD34 positive and CD117 negative, E: CD19 positive and CD20 negative, F: TDT positive and MPO negative, G: CD3 negative and CD79a positive, H: CD3 and CD7 negative
case_images: cureus-0016-00000052489-i03.jpg
case_images: PMC10874130_01_cureus-0016-00000052489-i03.jpg
case_images: FIG3
case_images: Flow cytometry revealed these blasts to be expressing HLA-DR++, CD45 dim+, CD34++, CD19+, CD10++, TDT+, and CD79a dim+ and were negative for MPO, CD3, CD20, and all other antigens (Figure 3).