was present in all of the biopsies and characteristic megakaryocytic pleomorphism was appreciated.
Also, it is characterized by panmyelosis
, meaning WBC and platelets are increased as well.
Polycythemia vera usually presents with panmyelosis
. Red blood cell precursors are hypersensitive to erythropoietin, (6) causing an increase in the RBC count, hematocrit, and hemoglobin.
AML with recurrent cytogenetic translocations AML with t(8;21)(q22;q22) Acute PML with t(15;17)(q22;q21) Variant acute PML with t(v;17) AML with abnormal bone marrow eosinophils inv(16)(p13;q22) or t(16;16)(p13;q22) AML with 11q23 abnormalities AML with multilineage dysplasia With prior myelodysplastic syndrome Without prior myelodysplastic syndrome AML and myelodysplastic syndrome, therapy related Alkylating agent related Topoisomerase II inhibitor related Other types AML not otherwise categorized AML minimally differentiated AML without maturation AML with maturation Acute myelomonocytic leukemia Acute monocytic leukemia Acute erythroid leukemia Acute megakaryocytic leukemia Acute basophilic leukemia Acute panmyelosis
with myelofibrosis Table 13.
(4-6) Acute megakaryoblastic leukemia may present as panmyelosis with myelofibrosis, usually considered in the differential diagnosis of either entity.
We report an unusual case of atypical presentation of CML with trisomy 19 presenting as panmyelosis with myelofibrosis, with predominance of atypical megakaryocytes, in a 61-year-old, previously healthy woman.
The marrow findings, in conjunction with clinical findings, raised a few differential diagnostic possibilities: primary myelofibrosis, acute megakaryoblastic leukemia, or acute panmyelosis with myelofibrosis.
In addition, when there is leukoerythroblastosis in the peripheral blood along with increased fibrosis and increased atypical megakaryocytes and megakaryoblasts, then the differential diagnosis includes acute megakaryoblastic leukemia, acute panmyelosis with myelofibrosis, and transformed primary myelofibrosis.
Acute myeloid leukemia without maturation, acute myeloid leukemia with maturation, and the blasts of acute panmyelosis
with myelofibrosis show nonspecific features, with frequent expression of markers associated with myeloid immaturity, such as CD34 and CD117, combined with variable expression of more general markers of myeloid lineage, including CD13, CD15, CD33, and CD64.