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HORIBA Chase the Case #56 -Acute Myeloid Leukemia
Discover how extended WBC differential parameters (LIC, IMG, IMM) identified abnormal cell populations consistent with blasts in an acute myeloid leukemia clinical case.
May 2026 (PDF for print)
Patient Demographics: Male, 49 years old
Symptoms: Fever of unknown origin (FUO) and body aches
Microscopic Review: Blasts 36%, neutrophils 35%, lymphocytes 15%, monocytes 10%, eosinophils 1%, metamyelocytes 3%, erythroblasts (nRBCs): 2/100 WBCs. Blasts are medium-to-large cells with round-to-irregular nuclear contours and a moderate amount of pale-to-deep blue cytoplasm, often containing azurophilic granules. The nuclei show fine, lacy chromatin with prominent nucleoli.
Other Tests: Bone marrow aspiration showed 60% blasts with dysplastic and atypical nucleated cells.
How Yumizen H2500 Assisted: The WBC differential revealed increased monocyte and LIC values, accompanied by elevated IMG and IMM levels (extended WBC differential). On the DIFF scattergram, these abnormalities reflect the presence of immature granulocytic cells originating from blasts (myeloblasts). The dispersion of the LIC population within the IMG and IMM matrix correlates with the morphological heterogeneity observed on microscopy. These parameters (IMG and IMM, the subtypes within the overall LIC population), available on the Yumizen H2500 hematology analyzer, support screening for hematological malignancies by facilitating blast detection within routine CBC microscopy workflows.
This clinical case has been provided by Dr. Tri Ratnaningsih, Universitas Gadjah Mada, Yogyakarta, Indonesia.
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