Color Atlas of Hematology - Practical Microscopic and Clinical ...

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94Abnormalities of the White Cell SeriesChromosome analysis provides important information. In practice,however, the diagnosis of acute leukemia is still based on morphologicalcriteria.However, where the possibilities of modern therapeutic and prognosticmethods are fully accessible, new laboratory procedures based on geneticand molecular biological testing procedures form part of the diagnosticwork-up of AML. The current WHO classification takes account of thesenew methods, placing genetic, morphological, and anamnestic findings ina hierarchical order (Table 15).According to the new WHO classification, blasts account for more than20% of cells in acute myeloid leukemia (in contradistinction to myelodysplasias).Table 15WHO classification of AMLAML with specificcytogenetic translocationsAML with dysplasia inmore than 1 cell line(2 or 3 cell linesaffected)*Therapy-induced AMLund MDSAML that does not fitany of the other categories– With t(8;21) (q22; q22), AML 1/ETO– Acute promyelocytic leukemia (AML M3 with t(15;17) (q22;q11-12) and variants, PML/RAR-α– With abnormal bone marrow eosinophils and (inv16)(p13;q22) or to t(16;16) (p13; q22); CBFβ/MYH 11– With 11q23 (MLL) anomalies– With preceding myelodysplastic/myeloproliferative syndrome– Without preceding myelodysplastic syndrome– After treatment with alkylating agents– After treatment with epipodophyllotoxin– Other triggers– AML, minimal differentiation– AML without cell maturation– AML with cell maturation– Acute myelomonocytic leukemia– Acute monocytic leukemia– Acute erythroid leukemia– Acute megakaryoblastic leukemia– Acute panmyelosis with myelofibrosis– Myelosarcoma/chloroma– Acute biphenotypic leukemia*** The dysplasia must be evident in at least 50% of the bone marrow cells and in 2–3 cell lines.** Biphenotypic leukemias should be classified according to their immunophenotypes. Theyare grouped between acute lymphocytic and acute myeloid leukemias.
Predominance of Mononuclear Round to Oval Cells95Acute Myeloid Leukemias (AML)Morphological analysis makes it possible to group the predominantleukemic cells into myeloblasts and promyeloblasts, monocytes, or atypical(lympho)blasts. A morphological subclassification of these maingroups was put forward in the French–American–British (FAB) classification(Table 14).In practical, treatment-oriented terms, the most relevant factor iswhether the acute leukemia is characterized as myeloid or lymphatic.Including the very rare forms, there are at least 11 forms of myeloidleukemia.
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iiiColor Atlas of HematologyPractic
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vPrefaceOur Current EditionAlthough
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viiContentsPhysiology and Pathophys
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ContentsixAcute Lymphoblastic Leuke
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2Physiology and Pathophysiology of
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Normal Cells of the Blood andHemato
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Normally erythropoiesis takes place
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34Normal Cells of the Blood and Hem
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36Normal Cells of the Blood and Hem
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Advancing nuclear contraction and s
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Note the granulations, inclusions,
Page 54 and 55: 44Normal Cells of the Blood and Hem
Page 71 and 72: Abnormalities of the White Cell Ser
Page 73 and 74: Predominance of Mononuclear Round t
Page 77 and 78: During lymphatic reactive states, v
Page 79 and 80: Extreme transformation of lymphocyt
Page 85 and 86: Monotonous proliferation of small l
Page 87 and 88: Atypical lymphocytes are not part o
Page 89 and 90: Deep nuclear indentation suggests f
Page 91 and 92: Cytoplasmic processes the main feat
Page 93 and 94: Plasmacytoma cannot be diagnosed wi
Page 95 and 96: Atypias and differential diagnoses
Page 97 and 98: Bone marrow diagnosis is indicated
Page 99 and 100: Conspicuously large numbers of mono
Page 103: Predominance of Mononuclear Round t
Page 107 and 108: Fundamental characteristic of acute
Page 109 and 110: The diagnosis of acute leukemia is
Page 111 and 112: Acute leukemias may also derive fro
Page 113 and 114: New WHO classification: AML with dy
Page 115 and 116: The cells in acute lymphocytic leuk
Page 117 and 118: In unexplained anemia and/or leukoc
Page 119 and 120: The classification of myelodysplasi
Page 121 and 122: Prevalence of Polynuclear (Segmente
Page 123 and 124: Predominance of the granulocytic li
Page 125 and 126: Prevalence of Polynuclear (Segmente
Page 127 and 128: Left shift as far as myeloblasts, p
Page 129 and 130: Bone marrow analysis is not obligat
Page 131 and 132: In the course of chronic myeloid le
Page 133 and 134: Enlarged spleen and presence of imm
Page 135 and 136: Eosinophilia and basophilia are usu
Page 137 and 138: Erythrocyte and ThrombocyteAbnormal
Page 139 and 140: Hypochromic Anemias129Insufficient
Page 141 and 142: Hypochromic Anemias131BSGIron Ferri
Page 143 and 144: Small, hemoglobin-poor erythrocytes
Page 145 and 146: Hypochromic erythrocytes of very va
Page 147 and 148: Hypochromic Anemias137Hypochromic S
Page 149 and 150: Hypochromic anemia without iron def
Page 151 and 152: Consistently elevated “young” e
Page 153 and 154: Distribution pattern and shape of e
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Conspicuous erythrocyte morphology
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Unexplained decrease in cell counts
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Hypochromic Anemias149Differential
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Thrombocytopenia with leukocytosis
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Conspicuous large erythrocytes sugg
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In older patients, myelodysplastic
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Small inclusions are usually a sign
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PlasmodiumfalciparumPlasmodiumvivax
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Conspicuous erythrocyte inclusions
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Bone marrow analysis contributes to
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Thrombocytes: increases, reductions
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Thrombocytes: increases, reductions
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Variant forms of thrombocyte and me
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Thrombocyte proliferation with larg
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Cytology of Organ Biopsiesand Exuda
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Lymph Node Cytology175Anamnesis- su
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Reactive lymph node hyperplasia and
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Lymph Node Cytology179Contact witha
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Epithelioid cells dominate the lymp
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In cases of non-Hodgkin lymphoma an
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Accessible cysts (e.g., branchial c
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Tumor cells can be identified in pl
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Viral, bacterial, and malignant men
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191IndexAActinomycosis 179Addison d
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Index193Disseminated intravascularc
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Index195blast crisis 120-121bone ma
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Index197in hemolytic anemia 140orth
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