The bone marrow biopsy is hypercellular and the marrow spaces are replaced with blast cells. The blasts are large in size with high N:C ratio, scant cytoplasm, hyperchromatic nuclei with inconspicuous nucleoli. There are areas of coagulative necrosis with presence of faint cell outlines and loss of nuclei. There is marked paucity oferythropoeisis, myelopoeisis and megakaryopoeisis in the sections examined. The blast shows strong membranous positivity for CD10 and CD 34 and focal nuclear positivity for TDT. A diagnosis of acute leukemia with areas of coagulative necrosis was made.