A 32-year-old man presents to the emergency department with a 2-week history of progressive fatigue, petechiae, and left upper quadrant abdominal pain. He denies fever, night sweats, or recent infections. Vital signs: BP 128/82 mmHg, HR 102/min, RR 20/min, temperature 37.8°C, SpO2 98% on room air. Physical examination reveals splenomegaly and diffuse petechiae. Laboratory studies: WBC 120,000/μL, hemoglobin 7.2 g/dL, platelets 30,000/μL, LDH 2800 U/L, uric acid 9.2 mg/dL, creatinine 1.0 mg/dL. Peripheral blood smear shows 80% blasts with abundant cytoplasm and Auer rods. Flow cytometry demonstrates: CD13+, CD33+, CD117+, MPO+, CD34+, HLA-DR+. Cytogenetic analysis reveals t(8;21)(q22;q22). Which of the following is the most likely diagnosis?

  1. A)Acute promyelocytic leukemia with t(15;17)
  2. B)Acute monocytic leukemia (AML-M5)
  3. C)Chronic myeloid leukemia in blast crisis
  4. D)Acute myeloid leukemia with t(8;21)(q22;q22) - RUNX1-RUNX1T1GABARITO
  5. E)Acute myeloid leukemia with inv(16)(p13q22)

Explicação

The diagnosis is AML with t(8;21)(q22;q22), which results in the RUNX1-RUNX1T1 fusion gene. This translocation is one of the most favorable prognostic acute myeloid leukemias in younger patients. The clinical presentation (hyperleukocytosis, splenomegaly, elev... Ver explicação completa e trilha adaptativa →

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