its very smart question

Thank you Hayder. Any opnion or suggestions?

I suggest to make discussion group every month one time and all people who have ex prince in morphology invite to share their knowledge

Yes, I agree

but I would like to see the starting of the discussion regarding this case!

Considering that blast cell percentage is about 40%, this can be a leukemia? type?

I wanted to share on RG this interesting case because it allows us to discuss some difficulties in morphological interpretation that can lead to relevant diagnostic errors. "Blast cells" which I described having increased size, exiguous cytoplasm, dispersed nuclear chromatin without evidence of nucleoli, might be classified as lymphoblasts. So a diagnosis of ALL could made. However, a careful observation of the images allows to detect some cellular fusions (Figure A on the left; Figure C right).The figure D, E and F above show the ability of these cells to form syncytia. Actually this is not an acute leukemia but a metastatic lung cancer (microcytoma) in the bone marrow

GOOD MORNING. IT WOULD BE VERY INTERESTING TO PARTICIPATE IN THESE EXERCISES, BUT NOT OCCUPYING OF HEMATOLOGICAL MORPHOLOGY DO NOT KNOW WHAT TO SAY. I work with ONCOEMATOLOGICAL CYTOMETRY AND THEREFORE I HAVE TO PROPOSE THE INTEGRATION OF MORPHOLOGY WITH THE CITOFLUORIMETRIC PHENOTYPE. THANK YOU.

Hi Viola

In this case immunophenotyping was nor performed. Hi agree with you that cytopluorimetric analysis is important in the diagnosis of hematological malignancies. You can find it in some of previous exercises and In the future I will try to report it (when available)