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CASE REPORT
Year : 2018  |  Volume : 4  |  Issue : 2  |  Page : 58-59

An Unusual Presentation of Atypical Lymphocytosis


1 Senior Resident, Dept of Biochemistry, IGIMS, Patna, India
2 Assistant Professor, Dept of Pediatrics NMCH, Patna, India
3 Haemato - oncologist, Paras HMRI Hospital, Patna, India
4 Professor, Dept of Biochemistry, IGIMS, Patna, India
5 Additional Professor, Department of Biochemistry, IGIMS, Patna, India
6 Associate Professor, Department of Biochemistry, IGIMS, Patna, India

Correspondence Address:
Priyanka Prasad
Senior Resident, Dept. of Biochemistry, IGIMS, Patna, Bihar
India
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Source of Support: None, Conflict of Interest: None


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A 2 years old boy presented with cold, cough, fever (respiratory distress) for 5 days and irritability for 3 days. On examination he had marked Pallor with hepatosplenomegaly. He was referred to the haematology depart-ment for work up. Complete Blood Count with Peripheral Blood film examination suggestive of Acute Lym-phoblastic Leukaemia. Atypical immature blasts are seen in peripheral blood. They have irregular nuclear outline with convolutions. RBCs show dismorphic cell population. Bone marrow aspiration showed presence of blast cells, fine nuclear chromatin with presence of nucleoli. Chest X ray revealed Hilar prominence. Morphologic findings are those of acute leukemia, possibly Acute lymphoblastic leukaemia (ALL) but Flow cytometry sug-gestive of 16% immature myelomonocytic precursor cells with monocytic differentiation. On follow up after 3 months no. of blasts cells and monocytic cells has come down significantly suggesting reactive cause of previ-ous proliferation exclude noninfectious causes(usually a hematologic malignancy).


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