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IMAGE IN HEMATOLOGY
Year : 2022  |  Volume : 13  |  Issue : 4  |  Page : 291

Green crystals of death in chronic myelogenous leukemia


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 Submission08-Jan-2022
Date of Decision13-Jan-2022
Date of Acceptance13-Jan-2022
Date of Web Publication18-Oct-2022

Correspondence Address:
Mohammad Esmaeil Khedmati
Department of Laboratory Sciences, School of Paramedical Sciences, Opposite Homa Hotel, Meshkinfam St., Shiraz
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joah.joah_1_22

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How to cite this article:
Khedmati ME, Mozaffari SK. Green crystals of death in chronic myelogenous leukemia. J Appl Hematol 2022;13:291

How to cite this URL:
Khedmati ME, Mozaffari SK. Green crystals of death in chronic myelogenous leukemia. J Appl Hematol [serial online] 2022 [cited 2022 Dec 4];13:291. Available from: https://www.jahjournal.org/text.asp?2022/13/4/291/358698

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.[1] 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.[2] 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.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Gorup T, Cohen AT, Sybenga AB, Edward S. Rappaport Baylor University Medical Center Proceedings. 2018;31:94-6.  Back to cited text no. 1
    
2.
Soos MP, Heideman C, Shumway C, Cho M, Woolf A, Kumar C. Blue-green neutrophilic inclusion bodies in the critically ill patient. Clin Case Rep 2019;7:1249-52.  Back to cited text no. 2
    


    Figures

  [Figure 1]



 

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