5.0 of 2 Ratings
49-year-old man complains of no symptoms, but on a routine complete blood count (CBC) has a white blood cell count of 40,000 per uL. A peripheral blood smear demonstrates leukocytosis with myeloid cells present at various stages of differentiation, with more mature cells present at a greater percentage than less mature cells (Figure A). What is the likely diagnosis?
Acute Lymphoblastic Leukemia (ALL)
Acute Myelogenous Leukemia (AML)
Chronic Lymphocytic Leukemia (CLL)
Chronic Myelogenous Leukemia (CML)
Acute Promyelocytic Leukemia (APL or APML)
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A 57-year-old man presents to the emergency department with several days of malaise, weakness, and night sweats. Today, he experienced a headache with blurry vision, thus prompting his presentation. The patient has a history of diabetes and is followed closely by an endocrinologist. Otherwise, he has lost 10 pounds over the past month. His temperature is 100°F (37.8°C), blood pressure is 122/90 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 99% on room air. Physical exam is notable for a thin man but is otherwise unremarkable. His visual acuity is 20/100 in both eyes, though he says that he normally has 20/20 vision. His gait is mildly ataxic as well, but his neurological exam is otherwise nonfocal. Laboratory studies are ordered as seen below.Hemoglobin: 10 g/dLHematocrit: 31%Leukocyte count: 57,500/mm^3 with 35% blastsPlatelet count: 109,000/mm^3 Serum:Na+: 139 mEq/LCl-: 100 mEq/LK+: 4.1 Eq/LHCO3-: 22 mEq/LBUN: 20 mg/dLGlucose: 99 mg/dLCreatinine: 1.1 mg/dLCalcium: 10.0 mEq/LWhich of the following is the most likely diagnosis?
Acute lymphoblastic leukemia
Acute myelogenous leukemia
Chronic lymphocytic leukemia
Chronic myelogenous leukemia
A 61-year-old woman presents to your office complaining of mild fatigue and weight loss over the past 6 months. She states she has felt generally unwell and has had decreased appetite during this time frame. Her temperature is 98.1°F (36.7°C), blood pressure is 122/80 mmHg, pulse is 88/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical exam reveals splenomegaly and a nontender abdomen. A complete blood count with differential shows the following:Hemoglobin: 10 g/dLHematocrit: 30%Leukocyte count: 166,500/mm^3Segmented neutrophils 92%Leukocyte alkaline phosphatase: LowPlatelet count: 92,000/mm^3A bone marrow biopsy is performed demonstrating infiltration with a large number of normal-appearing neutrophils. Which of the following translocations is likely to be seen in this patient?