Mixed lineage leukemia is a form of acute leukemia in which morphological , cytochemical and immunophenotypic features of cells lack sufficient evidence to classify as myeloid/ lymphoid in origin. It is a rare form of acute leukemia constituting about 4% of cases. This is a case report of a 17 year old girl who presented with complaints of fever for the past one month ,bleeding from nose off and on for the past one month and swelling of gums for the past one week. On haematological investigations, Hb was 6.2gm%, total leukocyte count was 58000/mm3. Peripheral smear showed leukocytosis composed almost exclusively of blasts. The blasts were large with a high nuclear-cytoplasmic ratio and scant cytoplasm. The cells had finely distributed nuclear chromatin and prominent nucleoli. Some blasts had slight cytoplasmic granularity. Auer rods were not seen . Bone marrow aspirate showed showed numerous immature cells with round-to-convoluted nuclei, many of them containing azurophilic granules. Rare Auer rods were seen. A presumptive diagnosis of acute myelogenous leukemia was made. On performing flow cytometry though, the diagnosis was confirmed as mixed lineage leukemia. This case is being presented for its rarity and unusual presentation.
: Nupur Sharma