case_images: PMC5546120_01
case_images: Bone marrow smear at diagnosis showed 70%-80% cellularity with decreased megakaryocyte, increased proportion of myeloid to erythroid cells, and high level of myeloid blasts which could be presumptive of AML-M4.
case_images: CRIHEM2017-9593750.001.jpg
case_images: PMC5546120_01_CRIHEM2017-9593750.001.jpg
case_images: fig1
case_images: The bone marrow aspiration smear (Figure 1) revealed 70%-80% cellularity with reduced megakaryocytes and raised ratio of myeloid to erythroid cells.
case_images: Karyotype analyses showed 46 XY compatible with the apparently normal male with no chromosomal aberration on the basis of GTG technique at 350-400 band resolution.
case_images: CRIHEM2017-9593750.002.jpg
case_images: PMC5546120_01_CRIHEM2017-9593750.002.jpg
case_images: fig2
case_images: CD13, CD14, CD33, CD34, CD45, CD64, HLA-DR, and c-MPO supported the AML-M4 based on French-American-British classification. Cytogenetic analysis demonstrated 46 XY compatible with the apparently normal male without chromosomal abnormality (Figure 2).
case_images: Bone marrow smears at spontaneous remission (2 weeks after sepsis resolution) showed 5-10% cellularity including sufficient megakaryocytes, myeloid and elytroid cells being in various maturation phases, and no blast.
case_images: CRIHEM2017-9593750.003.jpg
case_images: PMC5546120_01_CRIHEM2017-9593750.003.jpg
case_images: fig3
case_images: In addition, the bone marrow smear contained 5-10% cellularity with adequate megakaryocytes for this setting, myeloid and elytroid cells being in various maturation phases, and no blasts were recognized (Figure 3).
case_images: Bone marrow smear at spontaneous remission (4 weeks after sepsis resolution) showed 50-60% cellularity including sufficient megakaryocytes, the normal ratio of myeloid to elytroid cells, and no blast.
case_images: CRIHEM2017-9593750.004.jpg
case_images: PMC5546120_01_CRIHEM2017-9593750.004.jpg
case_images: fig4
case_images: Two weeks later, the bone marrow biopsy was repeated and the smear revealed 50-60% cellularity with sufficient megakaryocyte, the normal ratio of myeloid to erythroid cells, and no blast (Figure 4).