Bone marrow morphology and karyotype of case 1 at AML diagnosis. (A) Bone marrow aspirate blast morphology (left, Wright-Giemsa, ×100) and biopsy (right, Leder stain, ×100) demonstrating AML at diagnosis (stains were obtained from Richard-Allan Scientific, Kalamazoo, MI). The blast cells are medium-sized and have a high nuclear:cytoplasmic ratio, agranular Leder-negative cytoplasm, and visible nucleoli. Slides were viewed with an Olympus BX41 microscope (Olympus, Tokyo, Japan) at a 100×/1.30 NA oil objective with Resolve high-viscosity microscope immersion oil (Richard-Allan Scientific). Images were acquired using an Olympus DP70 camera and were processed with DP Controller 1.2.1.108 software (Olympus). Individual image files were assembled in Microsoft PowerPoint 2007. (B) AML karyotype showing trisomy 13 (arrow) at time of AML diagnosis (47,XY, + 13[5]/46,XY[15]).