PMC2799964_01
Computed tomography (CT) image of the upper abdomen demonstrates multiple splenic lacerations evidenced by the irregular, nonhomogeneous, low density of splenic body (red arrows).
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F1
The enhanced computed tomography (CT) scan of the abdomen/pelvis indicated multiple splenic lacerations, hepatosplenomegaly, and fluid collections in the perihepatic, perisplenic, both paracolic gutters, and pelvic cavity (Fig. 1).
(A) The spleen shows blood clots attached to the ruptured capsule (H-E stain, x20). (B) The spleen evidences diffuse invasion by immature myeloid cells (H-E stain, x200). (C) The infiltrates are composed principally of myeloperoxidase-positive immature myeloid cells (Myeloperoxidase stain, x400).
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F2
The microscopic findings of the spleen revealed diffuse infiltration of myeloperoxidase (MPO)-stained leukemic blasts (Fig. 2).
(A) This section shows hypercellular marrow with a cellularity of 70-80% and a diffuse infiltration of leukemic blasts (H-E stain, x400). (B) Leukemic blasts tested positive for myeloperoxidase (Myeloperoxidase stain, x1,000). (C) Leukemic blasts tested positive for PAS (PAS stain, x1,000).
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F3
We noted a marked proliferation of leukemic blasts, 48.6% of all nucleated cells, characterized by a high nuclear/cytoplasm ratio, fine nuclear chromatin, several distinct nucleoli, irregular nuclear and cytoplasmic membranes, and occasional cytoplasmic granules (Fig. 3).