Difficulties in the differential diagnosis of myelodysplastic syndrome and acute leukemia

The article presents a clinical observation of a patient with acute myeloid leukemia, which required differential diagnosis with myelodysplastic syndrome. At admission, the reason was the suspicion of decompensation of chronic heart failure, but the clinical and hematological picture required the exclusion of myeloproliferative disease. The differential diagnosis was complicated by the peculiarities of the myelogram data, and therefore it was necessary to repeat both the sternal puncture and the consultation with a hematologist. This observation illustrates that a single myelogram may not always serve as a sufficient and unambiguous guide, although it is certainly an important diagnostic method, and perhaps its features were due to the fact that we observed the process of transition of myelodysplastic syndrome to acute myeloid leukemia (this transformation is considered a "commonplace" in hematology, but there are practically no descriptions of the observation of its process in the literature).