case_images: PMC2799964_01
case_images: Computed tomography (CT) image of the upper abdomen demonstrates multiple splenic lacerations evidenced by the irregular, nonhomogeneous, low density of splenic body (red arrows).
case_images: ymj-51-138-g001.jpg
case_images: PMC2799964_01_ymj-51-138-g001.jpg
case_images: F1
case_images: The enhanced computed tomography (CT) scan of the abdomen/pelvis indicated multiple splenic lacerations, hepatosplenomegaly, and fluid collections in the perihepatic, perisplenic, both paracolic gutters, and pelvic cavity (Fig. 1).
case_images: (A) The spleen shows blood clots attached to the ruptured capsule (H-E stain, x20). (B) The spleen evidences diffuse invasion by immature myeloid cells (H-E stain, x200). (C) The infiltrates are composed principally of myeloperoxidase-positive immature myeloid cells (Myeloperoxidase stain, x400).
case_images: ymj-51-138-g002.jpg
case_images: PMC2799964_01_ymj-51-138-g002.jpg
case_images: F2
case_images: The microscopic findings of the spleen revealed diffuse infiltration of myeloperoxidase (MPO)-stained leukemic blasts (Fig. 2).
case_images: (A) This section shows hypercellular marrow with a cellularity of 70-80% and a diffuse infiltration of leukemic blasts (H-E stain, x400). (B) Leukemic blasts tested positive for myeloperoxidase (Myeloperoxidase stain, x1,000). (C) Leukemic blasts tested positive for PAS (PAS stain, x1,000).
case_images: ymj-51-138-g003.jpg
case_images: PMC2799964_01_ymj-51-138-g003.jpg
case_images: F3
case_images: We noted a marked proliferation of leukemic blasts, 48.6% of all nucleated cells, characterized by a high nuclear/cytoplasm ratio, fine nuclear chromatin, several distinct nucleoli, irregular nuclear and cytoplasmic membranes, and occasional cytoplasmic granules (Fig. 3).