Male 12 year, presented with severe anemia, moderate splenomegaly, moderate hepatomegaly, PS shows microcytic hypochromic anemia (Hb 3.5), with rouleaux formation, platelet low normal, total count appear low normal with neutrophils 70%. BM examination done 3 days after first BT given on the day of admission. cilincally ??acute leukemia. On bone marrow, there was mild erythroid hyperplasia, prominent toxic granulation in neutrophilic precursors. No significant number of blasts. Megakaryocytes appear within normal limits. Now after almost ruling out acute leukemia, second clinical possibility remains is of ?lipid storage or ?some chronic infection. I am posting few pictures here, does it suggest any storage disorder or just arteffects. Kindly give your opinions. I feel it is some chronic infection, but not sure. MP negative by slide and card. Kindly give your comments. Will try to post more pictures soon.
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