case_images: PMC10124558_01
case_images: Photomicrograph of A - peripheral blood smear; and B - bone marrow aspirate showing blast with coarse nuclear chromatin and prominent nucleoli. Some of the blasts had indented nuclei. (Leishman stain, x1000).
case_images: autopsy-13-e2023426-g01.jpg
case_images: PMC10124558_01_autopsy-13-e2023426-g01.jpg
case_images: gf01
case_images: The blast cells were round to oval, having coarse nuclear chromatin and prominent nucleoli, with a few cells containing indented nuclei (Figure 1A). Blasts accounted for 24% of the cellularity, with a myeloid: erythroid ratio of 14:1 (Figure 1B).
case_images: Flow cytometry showing blasts positive for: A - CD13; B - CD33; C - HLA-DR; D - FISH with dual fusion probe showing positive for BCR/ABL1 rearrangement.
case_images: autopsy-13-e2023426-g02.jpg
case_images: PMC10124558_01_autopsy-13-e2023426-g02.jpg
case_images: gf02
case_images: IPT, the blasts were positive for CD13, CD33, CD117, CD34 and HLA-DR but were negative for Tdt, CD3, CD4, CD7, CD19, and CD20 (Figure 2A, 2B and 2C). IPT findings confirmed the myeloid nature of the blasts. Abnormal clones with BCR-ABL1 (Breakpoint cluster region - Abelson gene) fusion were noted in 30.5% of cells (Figure 2D).