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Acute mast-cell leukemia. Bone marrow aspirate smears of a 79-year-old man with aleukemic acute mast-cell leukemia who presented with pancytopenia and abnormal liver function tests. The photomicrographs show round neoplastic cells with dark cytoplasmic granules. The cells were CD13+, HLA-DR+, CD33+, CD203c+, CD38+, CD2−, CD9−, CD123−, CD11b−, FcεRI+, CD117+, and CD25+. PCR was positive for C-KIT D816V mutation.
