Tantangan Diagnostik pada Leukemia Akut: Laporan Kasus tentang Hasil Pemeriksaan Sumsum Tulang yang Tidak Jelas dengan Adanya Sel Blast pada Sediaan Darah Perifer
Laporan Kasus
DOI:
https://doi.org/10.55175/cdk.v53i06.1939Kata Kunci:
Leukemia akut, sel blast, evaluasi sumsum tulang, laporan kasus, apusan darah tepi, trombositopeniaAbstrak
Pendahuluan: Leukemia akut adalah keganasan hematologis yang ditandai oleh proliferasi leukosit imatur yang mengganggu hematopoiesis normal, menyebabkan sitopenia dan gejala sistemik. Diagnosis umumnya berdasarkan evaluasi sumsum tulang. Temuan pada darah tepi dapat penting jika hasil sumsum tulang tidak meyakinkan. Kasus: Pria berusia 23 tahun dengan keluhan melena, anemia berat, kelemahan umum, dan nyeri punggung sejak dua minggu. Pemeriksaan fisik menunjukkan pucat dan splenomegali. Pemeriksaan laboratorium awal menunjukkan anemia makrositik berat, leukositosis, dan trombositopenia. Apusan darah tepi menunjukkan 63% sel blast dengan rasio inti-sitoplasma tinggi dan nukleolus yang menonjol. Meskipun temuan ini mendukung diagnosis leukemia akut, hasil aspirasi sumsum tulang tidak meyakinkan. Kadar lactate dehydrogenase yang meningkat mengindikasikan beban tumor yang tinggi. Pembahasan: Evaluasi apusan darah tepi didukung oleh pemeriksaan sitogenetik dan flow cytometry, sangat penting untuk diagnosis dini. Leukemia akut harus tetap menjadi pertimbangan diagnosis banding, meskipun temuan sumsum tulang belum definitif . Simpulan: Kasus ini menyoroti tantangan diagnostik leukemia akut dengan hasil aspirasi sumsum tulang awal yang tidak konklusif. Deteksi blast sirkulasi pada apusan darah tepi berperan penting dalam menegakkan diagnosis. Pengenalan dini melalui evaluasi diagnostik yang terintegrasi tetap esensial untuk memulai terapi secara tepat waktu.
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