A 33-year-old man has experienced multiple nosebleeds along with bleeding gums for the past month. On examination, his temperature is 37.3deg C. He has multiple cutaneous ecchymoses. Laboratory studies show hemoglobin, 8.5 g/dL; hematocrit, 25.7%; platelet count, 13,000/mm3; and WBC count, 52,100/mm3 with 5% segmented neutrophils, 5% bands, 2% myelocytes, 83% blasts, 3% lymphocytes, and 2% monocytes. Examination of his peripheral blood smear shows the blasts have delicate nuclear chromatin along with fine cytoplasmic azurophilic granules. These blasts are CD33+. Which of the following morphologic findings is most likely to be present on his peripheral blood smear?
Acute myelogenous leukemia (AML) infiltrates the marrow and reduces normal hematopoiesis to account for anemia and marked thrombocytopenia. The initial presentation may be acute. The Auer rods are condensations of the azurophilic granules. Dohle bodies, which are patches of dilated endoplasmic reticulum, and toxic granulations, which are coarse and dark primary granules, are reactive changes in mature neutrophils most indicative of marked inflammation, such as bacterial sepsis. Hairy projections are seen on the circulating B cells of hairy cell leukemia. Heinz bodies are seen in G6PD deficiency and are precipitates of denatured globin. Sickling of RBCs is a feature of sickle cell anemia, which is not related to leukemia.
Auer rods
Dohle bodies
Hairy projections
Heinz bodies
Blood