BONE MARROW ASPIRATE AND BIOPSY:
The bone marrow aspirate smear was dilute and hypocellular and suboptimal for evaluation. However, the biopsy was hypercellular (95% cellular) and was composed almost entirely of immature cells (blasts), usually with inconspicuous nucleoli and scant amounts of cytoplasm. Mitotic figures were easily found. Some nuclei exhibit a folded appearance. Scattered among the abnormal cells are small numbers of erythroid, myeloid and megakaryocytic cells. In the aspirate, the blasts demonstrated dispersed chromatin, rounded and folded nuclei and some exhibited cytoplasmic vacuoles. Occasional immature cells displayed slight granulation. The bony trabeculae were unremarkable.
Flow cytometric immunophenotypic studies were performed to further characterize the immature cells seen on the bone marrow biopsy:
MOLECULAR CYTOGENETIC ANALYSIS