This patient's blood film shows many hypergranulated promyelocytes (above and below) along with distinctive bilobed or 'butterfly' shaped blast cells. The white blood cell count is 35.42x109, haemoglobin 80g/L and a marked thrombocytopaenia with a platelet count of 26x109. These are reflected on the blood film. The thrombocytopaenia is genuine and no clumps were seen on the film. A manual differential count showed majority of the cells present were immature with very few mature cells.
Peripheral blood film image showing hypergranulated promyelocytes
Image from patient with APML showing promyelocytes and blast cells
There is polychromasia also present.
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Images: Personal photography.