case_images: PMC3459633_01
case_images: A - Presence of blastic cells in peripheral blood; B and C - Vacuolated monocytes with lobular or nuclear chromatin alterations and the presence of young cells of monocytic lineage; D - Presence of dysplasia in the granulocytic series
case_images: rbhh-34-242-g01.jpg
case_images: PMC3459633_01_rbhh-34-242-g01.jpg
case_images: F1
case_images: The peripheral blood analysis presented a total leukocyte count of 193,270 x 109/L, hemoglobin 6.1 g/dL, 9 erythroblasts and a platelet count of 79 x 109/L with 48% of blasts presenting a high nuclear:cytoplasm ratio, reticular chromatin and visible nucleoli, presence of 38% of granulocytes that had delayed maturation and some dysplastic characteristics such as hypogranular granulocytes, hypersegmented nucleus, vacuolated monocytes with irregular nuclei, and giant and hypogranular platelets (Figure 1).
case_images: A - The myeloid blasts are divided into two CD34++ populations. B - The red population expresses CD117+ and HLA-DR, showing that these cells may be producing a granulocytic lineage. C - Yet, the green cell population is CD117- and HLA-DR++. D and E - Markers of the second blastic population demonstrating CD36+ and CD64-
case_images: rbhh-34-242-g02.jpg
case_images: PMC3459633_01_rbhh-34-242-g02.jpg
case_images: F2
case_images: Both presented phenotypical characteristics and a maturation pattern of the monocytic lineage (Figure 2).