Virtual Slide: This 48-year-old man complains of fever and oral ulcers.

This 48-year-old man is seen for a fever of 3 days duration and oral ulcerations, bleeding gums and a sore throat. He also indicates ease of fatigue and bruisability. Physical exams reveals an apprehensive, pale man with oozing gums, oral ulcerations and numerous bruises of the lower legs. He is febrile, has a tachycardia and an increased respiration rate. There is no oragnomegaly and no adenopathy. WBC  47 X 103   RBC    3.08 Uric acid  10 mg/dL         Percent   HGB   10.4 LDH    250 IU/L NE      19.7   HCT     24.9   LY        1.8   MCV    80.8   MO        40   MCH    33.7 Reference values? EO          0   MCHC  41.6   BA          0   RDW    15.6   Blasts    38.5   PLT     119 X 103       MPV      7.0

Click the little red + in the smear above to see the slide using the virtual microscope. Describe what you see and then answer the following questions. What is a leukemia? How are acute leukemias classified? What do you think the bone marrow looks like? What is an Auer rod and what does it mean? See them in the picture? How to distinguish ALL form AML? What blood and urine test will help distinguish acute monocytic leukemia from acute granulocytic? Why the oral ulcers and easy of bruising? The next patient is a listless 5 year-old.

This picture is from another patient with a similar but different form of this disease

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