{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:06:16Z","timestamp":1789031176510,"version":"build-2803163510"},"reference-count":8,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_almed-2025-0184_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To report a rare case of acute myeloid leukemia (AML) with abnormal chromatin clumping (ACC) in myeloblasts mimicking chronic lymphocytic leukemia (CLL), highlighting the associated diagnostic challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_almed-2025-0184_abs_002\">\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      An 82-year-old woman presented with fatigue, weight loss, and pancytopenia. Peripheral blood film revealed 90\u202f% small mononuclear cells with clumped chromatin and basket cells reminiscent of CLL. Flow cytometry of peripheral blood demonstrated a dim CD45-positive blast population negative for B-cell markers (CD19, CD20, CD10) and lacking light-chain restriction. Bone marrow aspiration confirmed hypercellularity with 94\u202f% blasts expressing CD34, CD117, CD123, MPO, and aberrant CD7. Cytogenetic analysis revealed a complex karyotype with 46,XX, 1p36 abnormalities, and next-generation sequencing identified mutations in\n                      <jats:italic>EZH2, PHF6, WT1,<\/jats:italic>\n                      and\n                      <jats:italic>STAG2<\/jats:italic>\n                      . The final diagnosis was AML with myelodysplasia-related mutations (adverse risk, ELN-2022). Despite cytoreductive therapy, the patient showed no response and died within three\u00a0weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_almed-2025-0184_abs_003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case highlights the diagnostic challenge posed by AML with ACC, a morphology that can closely resemble CLL. Recognition of this pattern is essential to avoid misclassification, as therapeutic strategies and prognosis differ significantly. Only three similar cases have been reported, underscoring the exceptional rarity and clinical importance of this presentation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/almed-2025-0184","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:02:21Z","timestamp":1779192141000},"page":"229-233","source":"Crossref","is-referenced-by-count":1,"title":["Appearances can be deceptive: acute myeloid leukaemia simulating chronic lymphocytic leukaemia"],"prefix":"10.1515","volume":"7","author":[{"given":"Beatriz G\u00f3mez","family":"Horsefield","sequence":"first","affiliation":[{"name":"Institut Catal\u00e0 Oncologia , Girona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Cruz","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Institut Catal\u00e0 Oncologia , Girona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Garz\u00f3 Moreno","sequence":"additional","affiliation":[{"name":"Institut Catal\u00e0 Oncologia , Girona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esperanza","family":"Tuset Andujar","sequence":"additional","affiliation":[{"name":"Institut Catal\u00e0 Oncologia , Girona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leire Saiz","family":"Sierra","sequence":"additional","affiliation":[{"name":"Laboratori Territorial ICS-IAS Girona , Hospital Universitari Doctor Josep Trueta , Girona , Spain"},{"name":"Comisi\u00f3n de Hematolog\u00eda de la Sociedad Espa\u00f1ola de Medicina de Laboratorio (SEMEDLAB) , Girona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9983-9767","authenticated-orcid":false,"given":"Maite Serrando","family":"Querol","sequence":"additional","affiliation":[{"name":"Laboratori Territorial ICS-IAS Girona , Hospital Universitari Doctor Josep Trueta , Girona , Spain"},{"name":"Comisi\u00f3n de Hematolog\u00eda de la Sociedad Espa\u00f1ola de Medicina de Laboratorio (SEMEDLAB) , Girona , Spain"},{"name":"Research Group of Clinical Anatomy, Embryology and Neuroscience (NEOMA), Department of Medical Sciences , University of Girona , Girona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"2026091008070975181_j_almed-2025-0184_ref_001","doi-asserted-by":"crossref","unstructured":"Skeith, L, Lee, A. Abnormal chromatin clumping in myeloblasts. Blood 2016;127:2645. https:\/\/doi.org\/10.1182\/blood-2016-02-698506.","DOI":"10.1182\/blood-2016-02-698506"},{"key":"2026091008070975181_j_almed-2025-0184_ref_002","doi-asserted-by":"crossref","unstructured":"Shang, H, Li, R, Chai, X, Chen, X, Liu, K. AML-MRC with basophilia mimicking CLPD due to abnormally clumped chromatin. Indian J Hematol Blood Transfus 2020;36:781\u20133. https:\/\/doi.org\/10.1007\/s12288-020-01304-w.","DOI":"10.1007\/s12288-020-01304-w"},{"key":"2026091008070975181_j_almed-2025-0184_ref_003","doi-asserted-by":"crossref","unstructured":"Sehgal, T, Gaur, M, Kumar, G, Subramanian, A. Abnormal chromatin clumping in myeloblasts mimicking chronic lymphocytic leukaemia: a diagnostic pitfall. Cureus 2021;13:e20658. https:\/\/doi.org\/10.7759\/cureus.20658.","DOI":"10.7759\/cureus.20658"},{"key":"2026091008070975181_j_almed-2025-0184_ref_004","doi-asserted-by":"crossref","unstructured":"Arber, DA, Orazi, A, Hasserjian, RP, Borowitz, MJ, Le Beau, MM, Bloomfield, CD, et al.. The international consensus classification of myeloid neoplasms and acute leukemias: integrating morphological, clinical, and genomic data. Blood 2022;140:1200\u201328. https:\/\/doi.org\/10.1182\/blood.2022015850.","DOI":"10.1182\/blood.2022015850"},{"key":"2026091008070975181_j_almed-2025-0184_ref_005","doi-asserted-by":"crossref","unstructured":"Alaggio, R, Amador, C, Anagnostopoulos, I, Attygalle, AD, Araujo, IBde O, Berti, E, et al.. The 5th edition of the world health organization classification of haematolymphoid tumours: lymphoid neoplasms. Leukemia 2022;36:1720\u201348. https:\/\/doi.org\/10.1038\/s41375-022-01620-2.","DOI":"10.1038\/s41375-022-01620-2"},{"key":"2026091008070975181_j_almed-2025-0184_ref_006","doi-asserted-by":"crossref","unstructured":"Shimony, S, Stahl, M, Stone, RM. Acute myeloid leukemia: 2023 update on diagnosis, risk stratification, and management. Am J Hematol 2023;98:502\u201326. https:\/\/doi.org\/10.1002\/ajh.26822.","DOI":"10.1002\/ajh.26822"},{"key":"2026091008070975181_j_almed-2025-0184_ref_007","doi-asserted-by":"crossref","unstructured":"Felman, P, Bryon, PA, Gentilhomme, O, Ffrench, M, Charrin, C, Espinouse, D, et al.. The syndrome of abnormal chromatin clumping in leucocytes: a myelodysplastic disorder with proliferative features? Br J Haematol 1988;70:49\u201354. https:\/\/doi.org\/10.1111\/j.1365-2141.1988.tb02433.x.","DOI":"10.1111\/j.1365-2141.1988.tb02433.x"},{"key":"2026091008070975181_j_almed-2025-0184_ref_008","doi-asserted-by":"crossref","unstructured":"Dusse, LM, Moreira, AM, Vieira, LM, Rios, DR, Silva, RM, Carvalho, MD. Acquired Pelger-Hu\u00ebt: what does it really mean? Clin Chim Acta 2010;411:1587\u201390. https:\/\/doi.org\/10.1016\/j.cca.2010.07.012.","DOI":"10.1016\/j.cca.2010.07.011"}],"container-title":["Advances in Laboratory Medicine \/ Avances en Medicina de Laboratorio"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/almed-2025-0184\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/almed-2025-0184\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T08:08:55Z","timestamp":1789027735000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/almed-2025-0184\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":8,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,7,7]]},"published-print":{"date-parts":[[2026,9,9]]}},"alternative-id":["10.1515\/almed-2025-0184"],"URL":"https:\/\/doi.org\/10.1515\/almed-2025-0184","relation":{},"ISSN":["2628-491X"],"issn-type":[{"value":"2628-491X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]}}}