05-04-2007, 04:31 AM
A 50-year-old man comes to the physician because of gingival bleeding, epistaxis, and fever for 2 days. He appears acutely ill. His temperature is 39 C (102 F), blood pressure is 120/70 mm Hg, pulse is 120/min, and respirations are 22/min. Bilateral rhonchi are heard on chest examination. He is admitted for further evaluation. Chest x-ray shows bibasilar infiltrates consistent with bronchopneumonia. Blood tests show 12,000 leukocytes/mm3 with numerous myeloid blasts. Platelet count is 15,000/mm3. A bone marrow biopsy demonstrates hypercellular marrow, with 35% blasts. Elongated cytoplasmic inclusions consistent with Auer rods are appreciated in peripheral and marrow blasts. Which of the following is the most likely diagnosis?
(A) Acute lymphocytic leukemia (ALL)
(B) Acute myelogenous leukemia (AML)
© Chronic myelogenous leukemia (CML)
(D) Leukemoid reaction
(E) Myelodysplastic syndrome
(A) Acute lymphocytic leukemia (ALL)
(B) Acute myelogenous leukemia (AML)
© Chronic myelogenous leukemia (CML)
(D) Leukemoid reaction
(E) Myelodysplastic syndrome