Acute leukemias

Infiltration of spleen leading to splenomegaly is a common feature in acute leukemias. Detection of medium to large blast cells is the main cytologic finding. In most cases, immunophenotyping is mandatory to define the neoplastic cell lineage. However, morphology may help to suggest cellular origin in some specific acute myeloid leukemias, such as erythroleukemia or megakaryocytic leukemia (Figure 5.80).

Figure 5.80 Same case as Figure 8.78. Megakaryoblastic leukemia. A large neoplastic megakaryoblast (May–Grünwald–Giemsa, 1,000? magnification).