Haematology: AML with maturation and myeloid sarcoma: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Haematology: AML with maturation and myeloid sarcoma

Sample item

A 25-year-old man has pancytopenia and 35 percent marrow blasts with Auer rods and large salmon-pink granules. Biopsy of a greenish orbital mass shows the same blasts. Which cytogenetic abnormality is most likely and how does it affect prognosis?

At(9;22), with an adverse prognosisBt(15;17), with a favourable response to retinoic acidCinv(3), with an adverse prognosisDt(8;21), with a favourable prognosis

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. t(8;21), with a favourable prognosis

AML with t(8;21) typically shows blasts with Auer rods and large pink granules, and extramedullary myeloid sarcoma (chloroma) is a recognised feature. It carries a relatively good response to cytarabine-based therapy.

Option by option

A. t(9;22), with an adverse prognosis
t(9;22) defines chronic myeloid leukaemia and some adult acute lymphoblastic leukaemia, not AML with granulated blasts.
B. t(15;17), with a favourable response to retinoic acid
t(15;17) defines acute promyelocytic leukaemia with a bleeding diathesis from coagulopathy, not this picture.
C. inv(3), with an adverse prognosis
inv(3) is an adverse-risk AML abnormality associated with thrombocytosis and does not give this morphology.
D. t(8;21), with a favourable prognosis (correct)
Correct. t(8;21) is linked to Auer rods, large granules and myeloid sarcoma, with a favourable outcome.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, t(8;21), with a favourable prognosis. AML with t(8;21) typically shows blasts with Auer rods and large pink granules, and extramedullary myeloid sarcoma (chloroma) is a recognised feature.

Why is "t(9;22), with an adverse prognosis" not the answer?

t(9;22) defines chronic myeloid leukaemia and some adult acute lymphoblastic leukaemia, not AML with granulated blasts.

Why is "t(15;17), with a favourable response to retinoic acid" not the answer?

t(15;17) defines acute promyelocytic leukaemia with a bleeding diathesis from coagulopathy, not this picture.

Why is "inv(3), with an adverse prognosis" not the answer?

inv(3) is an adverse-risk AML abnormality associated with thrombocytosis and does not give this morphology.

What concept does this question test?

It tests Haematology: AML with maturation and myeloid sarcoma in Pathology. It carries a relatively good response to cytarabine-based therapy.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematology: AML with maturation and myeloid sarcoma?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.