A 30 year old man presents with dull pain in his right hip, which started 4 months ago, and has gradually increased in severity. He also experienced an intermittent, low grade fever during this time. His medical and surgical histories are unremarkable. He does not smoke or consume alcohol, and denies drug abuse. A complete blood count reveals a total leukocyte count of 15,000/mm3, a neutrophil count of 1,510/mm3, a Hb level of 9.1 g/dL and a platelet count of 118,000/mm3. A followup peripheral blood smear demonstrates 15% blast cells.
The x-ray reveals ill defined areas of radiolucency in the right iliac bone, right acetabular bone and marrow spaces.
The bone marrow contains 36% blasts. Blasts were negative for peroxidase (POX) and naphthol AS-D chloroacetate esterase (CE) indicating a myeloid lineage. The biopsy demonstrates a fibrotic marrow with areas of hyperplasia.
A flow cytometric analysis (FCM) demonstrates positive HLA DR+, CD117+, CD34+, CD33+, CD38+, cMPO+ in abnormal cells, confirming myeloid phenotype.
Result will be available in 1 week