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    Osmosis 41

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    Sarawini Kosolsombat
    1) This patient presented with fatigue, weakness, weight loss, and abdominal bloating and was found to have anemia, low platelet count, and high white blood cell count. 2) Examination revealed an enlarged liver and spleen, and testing showed changes consistent with acute myeloid leukemia (AML). 3) AML is characterized by excessive growth of immature white blood cells in the bone marrow, which crowds out normal cells.

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    Osmosis 41

    Uploaded by

    Sarawini Kosolsombat
    31 views1 page
    1) This patient presented with fatigue, weakness, weight loss, and abdominal bloating and was found to have anemia, low platelet count, and high white blood cell count. 2) Examination revealed an enlarged liver and spleen, and testing showed changes consistent with acute myeloid leukemia (AML). 3) AML is characterized by excessive growth of immature white blood cells in the bone marrow, which crowds out normal cells.

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    1) This patient presented with fatigue, weakness, weight loss, and abdominal bloating and was found to have anemia, low platelet count, and high white blood cell count. 2) Examination revealed an enlarged liver and spleen, and testing showed changes consistent with acute myeloid leukemia (AML). 3) AML is characterized by excessive growth of immature white blood cells in the bone marrow, which crowds out normal cells.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    31 views1 page

    Osmosis 41

    Uploaded by

    Sarawini Kosolsombat
    1) This patient presented with fatigue, weakness, weight loss, and abdominal bloating and was found to have anemia, low platelet count, and high white blood cell count. 2) Examination revealed an enlarged liver and spleen, and testing showed changes consistent with acute myeloid leukemia (AML). 3) AML is characterized by excessive growth of immature white blood cells in the bone marrow, which crowds out normal cells.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    Major takeaway

    AML is defined as clonal expansion of malignant immature myeloid cells
    A 68-year-old male comes to his provider’s office for evaluation of fatigue,
    (>20%) in the bone marrow secondary to mutations. It usually presents with
    weakness, and 8 kg (17.6 lb) unintentional weight loss over the past 2
    anemia (fatigue, dyspnea), thrombocytopenia (easy bruising), and abnormal
    months. Moreover, the patient reports feeling bloated after eating small
    leukocyte function (infections). Peripheral smear shows myeloblasts with
    quantities of food during this same time period. His past medical history is
    nuclear atypia, fine azurophilic granules and Auer rods.  
    notable for hypertension, and the patient is currently taking
    hydrochlorothiazide. Physical exam reveals oral mucosal pallor. Cardiac and
    Main explanation
    pulmonary exams are non-contributory. Abdominal exam reveals
    hepatosplenomegaly. Laboratory testing
    This patient's clinical presentation results
    (fatigue, are asinfollows:
    dyspnea)  
    combination with
     laboratory evidence of anemia, thrombocytopenia and leukocytosis, and
    peripheral
     Laboratoryblood
    value smear showing myeloblasts with Auer
     Result  rods, is consistent
    with acute myeloid leukemia (AML).  
     Hemoglobin   9.5 g/dL 
     Hematocrit   28.5% 
    AML is defined as clonal expansion of malignant immature myeloid
     Leukocytes  in the bone marrow. It usually 2,700/mm3 
    cells (>20%) arises in older adults (average
     Platelets 
    50-60  100,000/mm3 
    years) and is mostly a result of acquired chromosomal abnormalities,
    particularly translocations. These mutations cause proliferation of immature
    myeloidofcells
    Biopsy the in the marrow
    bone bone marrow,
    biopsywhich
    showssuppresses
    increased the growth
    fibrosis andand
    reduced cell
    proliferation
    count. of otherchain
    Polymerase hematopoietic
    reaction stem cells.
    testing Risk factors
    reveals for the in a gene
    a mutation
    development
    encoding for aofnon-receptor
    AML includetyrosine
    radiation, chemotherapy (as
    kinase. Which of theinfollowing
    this patient),
    diseases
    tobacco
    is smoking,
    also caused Down
    by an syndrome,
    identical and myeloproliferative disorders.
    mutation?

    AML is divided into eight types (M0 through M7) based on cytogenetic
    Elimination tool
    abnormalities, cell lineage and surface markers. It commonly presents with
    signs and symptoms of pancytopenia (fatigue, dyspnea, easy bruising and
    A. Laboratory
    infections). Fanconi anemia
    analysis may show normochromic normocytic anemia,
    thrombocytopenia and leukocytosis (due to circulating blasts). Peripheral
    Show explanation ⌄
    blood smear reveals myeloblasts with nuclear atypia and fine azurophilic
    granules. Auer rods are pathognomonic of AML and appear as pink/red rod-
    like granular structures in the cytoplasm, as shown with the arrow below.
    B.diagnosis
    Definitive Acute myeloid leukemia
    requires bone marrow aspiration and
    biopsy showing ≥20% blast cells.  
    Show explanation ⌄

    C. Follicular lymphoma

    Show explanation ⌄

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