A 34-year-old man presents to the emergency department with symptoms of fatigue, weakness, nose bleeds, and palpitations with exertion. The symptoms started 1 week ago and are getting worse every day. He has no prior health issues and is not taking any medications. On examination, he is pale, blood pressure 110/70 mm Hg, pulse 100/min, heart sounds are normal, lungs are clear, and he has multiple petechiae and bruises on his legs.His blood count is abnormal; hemoglobin 8.5 g/dL, white blood cells (WBCs) 4000/mL, platelets 50,000/mL, and there are blast cells in the peripheral blood. He is diagnosed with acute promyelocytic leukemia (AML-M3). (See Figure below) Which of the following is a characteristic of this acute myelogenous leukemia?
peak incidence in childhood
high leukocyte alkaline phosphatase
Philadelphia chromosome
Auer bodies in blast cells
The image shows Auer bodies in the blast cell, they are slender, pink staining rods containing lysozyme, and are exclusively seen in AML. Although similar to normal azurophilic granules in content and staining properties, they are distinguished by their gigantic size. Special stains can enhance the detection of Auer bodies. They are only seen in a minority of cases. The Philadelphia chromosome is a feature of choric myelogenous leukemia (CML), and a high leukocyte alkaline phosphatase level is seen in patients with a high WBC due to a leukemoid reaction.
Blood