|IMAGE IN HEMATOLOGY
|Year : 2022 | Volume
| Issue : 4 | Page : 291
Green crystals of death in chronic myelogenous leukemia
Mohammad Esmaeil Khedmati1, Sara Kohan Mozaffari2
1 Department of Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
2 Department of Genetics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
|Date of Submission||08-Jan-2022|
|Date of Decision||13-Jan-2022|
|Date of Acceptance||13-Jan-2022|
|Date of Web Publication||18-Oct-2022|
Mohammad Esmaeil Khedmati
Department of Laboratory Sciences, School of Paramedical Sciences, Opposite Homa Hotel, Meshkinfam St., Shiraz
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Khedmati ME, Mozaffari SK. Green crystals of death in chronic myelogenous leukemia. J Appl Hematol 2022;13:291
A 49-year-old man with a history of chronic myelogenous leukemia presented for laboratory workup. Admission workup showed macrocytic anemia (hemoglobin 63 g/dl and mean corpuscular volume 111.5 fl), white blood count 189.80 × 109/l, and platelet count >1000 × 109/l. A complete blood count manual differential shows severe leukocytosis. Monocyte [Figure 1] shows blue-green intracellular inclusions previously termed “Green Crystals of Death,” and the patient died on the 2nd day of hospitalization.
|Figure 1: Monocyte showing blue-green intracellular inclusions (wright stain, ×100 objective)|
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This inclusion body is a rare clinical finding within the cytoplasm of neutrophils or monocytes as a sign for increased risk of morbidity and mortality. It is suggested that the inclusions likely originated from lipofuscin and are most often associated with acute liver failure, lactic acidosis with multisystem organ failure secondary to trauma, and Escherichia coli-associated septic shock. It may be useful to notify the health-care professionals to consider evaluating for liver damage and lactic acidosis.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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Conflicts of interest
There are no conflicts of interest.
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