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Systemic mastocytosis (SM) with an associated clonal haematological non-mast cell lineage disease: SM with an associated acute myeloid leukaemia. Chloroacetate esterase (CAE) staining shows an extremely hypercellular bone marrow with a monotonous picture, which is dominated by strongly positive atypical myeloid cells and blast cells. Note the periphery of a small CAE negative infiltrate at the upper left quadrant of the picture. Naphthol AS-D chloroacetate esterase stain.
