PMC5993362_01
(a) Peripheral blood showing atypical cells initially interpreted as atypical lymphocytes, (b) Bone marrow aspirate showing myeloblasts with agranular cytoplasm and basophils, (c) Bone marrow biopsy showing many dysplastic megakaryocytes and increased immature cells.
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The peripheral blood smear showed many atypical cells with round to oval nuclei with clumped chromatin, occasional nucleoli and a small to moderate amount of bluish peripheral cytoplasm, initially interpreted as atypical lymphocytes (Fig. 1). Bone marrow aspirate showed myeloblasts with agranular cytoplasm and basophils (Fig. 1). Megakaryocytes were increased and appeared dysplastic (Fig. 1).
Karyotype demonstrating t(4;12)(q12;p13) and 5q deletion.
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Cytogenetics showed an abnormal female karyotype in 20 cells with a translocation between the long arm of chromosome 4 and the short arm of chromosome 12 (Fig. 2).