9-year-old boy was diagnosed with stage III ALK-positive anaplastic large cell lymphoma (ALCL) with no evidence of bone marrow and central nervous system disease. Seven months later he had a normocytic anemia (hemoglobin 79 g/L), severe thrombocytopenia (platelets 15 X 10~9/L), and leukocytosis (white blood cell count 50.8 X 10~9/L). The automated differential showed neutrophils 28.5 X 10~9/L, monocytes 13.2 X 10~9/L, and "other" cells 4.6 X 10~9/L. The peripheral blood smear (shown) contained large immature cells with basophilic cytoplasm and prominent cytoplasmic vacuolation. Karyorrhexis, pyknosis, and karyolysis were also seen in the large immature cells. Red blood cell morphology showed numerous echinocytes (also known as burr cells), which were likely a consequence of renal failure (creatinine 162muM, urea 12.9mM).
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机译：9岁男孩被诊断患有III期ALK阳性的间变性大细胞淋巴瘤（ALCL），没有证据显示骨髓和中枢神经系统疾病。七个月后，他出现了正常性贫血（血红蛋白79 g / L），严重的血小板减少（血小板15 X 10〜9 / L）和白细胞增多（白细胞计数50.8 X 10〜9 / L）。自动鉴别显示中性粒细胞为28.5 X 10〜9 / L，单核细胞为13.2 X 10〜9 / L，“其他”细胞为4.6 X 10〜9 / L。外周血涂片（如图所示）包含大的未成熟细胞，具有嗜碱性的细胞质和突出的细胞质空泡。在未成熟的大细胞中也可见到核仁溢血，脓肿和核仁溶解。红细胞形态显示许多棘突细胞（也称为毛刺细胞），可能是肾功能衰竭的结果（肌酸酐162μM，尿素12.9mM）。
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