case_images: PMC7268156_01
case_images: (a) Left axillary mass 5 x 5 cm, (b) chest radiograph reveals diffuse nodular pulmonary infiltrations, and (c) computed tomography of pulmonary arteries shows pulmonary vessels well opacified with no filling defects.
case_images: 10.1177_2050313X20926076-fig1.jpg
case_images: PMC7268156_01_10.1177_2050313X20926076-fig1.jpg
case_images: fig1-2050313X20926076
case_images: She had a left axillary swelling of 5 x 5 cm (Figure 1(a)) which was firm, non-tender with no discharge. The chest radiograph (Figure 1(b)) revealed diffuse nodular pulmonary infiltrations. The computed tomography of the pulmonary arteries (Figure 1(c)) showed no features of pulmonary embolism.
case_images: (a) Peripheral blood film shows moderate-to-large sized blasts with bilobed nuclei and presence of faggot cells. (b) Bone marrow aspirate reveals many moderate-to-large sized blasts with prominent nucleoli, bilobed cells and faggot cells. (c) Trephine biopsy microscopy (H&E x 40) shows hypercellular marrow which comprises almost entirely of blasts. (d-f) Panel of immunohistochemical staining (40x magnifications) shows diffuse positivity of MPO, negativity for CD34 and reactive CD3 cells.
case_images: 10.1177_2050313X20926076-fig2.jpg
case_images: PMC7268156_01_10.1177_2050313X20926076-fig2.jpg
case_images: fig2-2050313X20926076
case_images: The peripheral blood smear (Figure 2(a)) and bone marrow aspirate (Figure 2(b)) showed presence of blasts, abnormal promyelocytes and faggot cells. The trephine biopsy microscopy (Figure 2(c)) showed a hypercellular marrow which comprised almost entirely of blast population expressing myeloperoxidase (MPO) but lacking CD34 and CD3 on immunohistochemistry (Figure 2(d)-(f)).