TY - CHAP M1 - Book, Section TI - ACUTE LYMPHOCYTIC LEUKEMIA A1 - Hillman, Robert S. A1 - Ault, Kenneth A. A1 - Leporrier, Michel A1 - Rinder, Henry M. Y1 - 2016 N1 - T2 - Hematology in Clinical Practice, 5e AB - CASE HISTORY • Part 1A 16-year-old female presents with the recent onset of fatigue, headache, and repeated, difficult to control, epistaxis over the past week. She has been in excellent health and has no personal or family history of serious illness. She has 4 siblings.Examination reveals pale conjunctiva and multiple petechiae on her lower legs. Abdominal examination suggests a slightly enlarged spleen. The remainder of her examination, including a neurological examination is normal.Table Graphic Jump Location|Download (.pdf)|PrintCBC: Hematocrit/hemoglobin 25%/8 g/dLMCV - 90 fL MCH - 32 pg MCHC - 31 g/dLWBC count - 110,000/μLDifferential count:Neutrophils 10%Mature lymphocytes 3%Immature blasts 85%Monocytes/eosinophils/basophils <1%Platelet count - 45,000/μLSMEAR MORPHOLOGYNormocytic, normochromic red blood cells with the occasional shift cell (polychromasia). Dominant population of blasts—moderately large cells with little cytoplasm and prominent nucleoli surrounded by an abnormal nuclear chromatin pattern; the few remaining neutrophils and lymphocytes appear normal. Platelets are reduced in number.QuestionsWhat abnormality is apparent from the CBC?What further studies are indicated? SN - PB - McGraw-Hill Medical CY - New York, NY Y2 - 2024/03/28 UR - accessbiomedicalscience.mhmedical.com/content.aspx?aid=1127767794 ER -