Paper I — 2024 June (Supplementary) (2019 Scheme) — Q11

Paper I

2024 June (Supplementary) (2019 Scheme) · 100 marks · 180 min

Question

Peripheral blood picture in acute myeloid leukemia

Q114 marksShort Answers★✓

Answer

Peripheral blood picture in acute myeloid leukaemia

• Presence of circulating myeloblasts — large cells with a high nuclear:cytoplasmic ratio, fine/dispersed chromatin, and prominent nucleoli
• Auer rods may be seen within the cytoplasm of myeloblasts — thin, needle-like eosinophilic inclusions formed from fused primary (azurophilic) granules; pathognomonic for myeloid lineage when present
• “Hiatus leukaemicus”: A gap in maturation, with numerous blasts and mature neutrophils but few intermediate maturation forms (myelocytes, metamyelocytes), unlike the smoother maturation continuum seen in chronic myeloid leukaemia
• Anaemia — normocytic normochromic, due to marrow replacement by leukaemic blasts
• Thrombocytopenia — due to marrow infiltration suppressing normal megakaryopoiesis
• Total leucocyte count is variable — can be markedly elevated, normal, or even reduced (aleukaemic leukaemia), depending on the degree of blast release into circulation
• Cytochemical stains (myeloperoxidase, Sudan Black B) positive in the blasts, confirming myeloid lineage

Related Concepts

1. 1Acute Leukaemia

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