title: Generalised leukaemic gingival enlargement: a case report.
abstract: BACKGROUND
  Acute myeloblastic leukaemia is a malignant bone marrow neoplasm of myeloid precursors of white blood cells. Due to its high morbidity rate, early diagnosis and appropriate medical therapy is essential.
  
  
  METHODS
  The article highlights normal blood alterations like anaemia, thrombocytopenia, leukocytosis and advanced diagnostic aids like flow cytometry, special staining as a diagnostic modality as well as for prognostic information in acute leukaemia, particularly as a tool for assigning lineage and facilitating further pathologic classification which may be helpful in influencing treatment strategies.
  
  
  RESULTS
  On clinical examination the case presented with features of inflammatory gingival enlargement with presence of local deposits and calculus. Routine blood examination anaemia, thrombocytopenia, leukocytosis with haemoglobin 5.6 gm% and total leukocyte count of 1,12,000 / cu mm suggestive of leukaemia. Myeloperoxidase and leukocyte nonspecific esterase (NSE) special stain were used which showed presence of myeloblasts in the peripheral smear suggestive of acute myelocytic leukaemia. Flow cytometry were done which further helped in interpretation of these cells which showed to be strongly positive for CD45, CD13, CD14, and anti HLADR and moderately positive for CD4, CD34 and Anti MPO confirming to be case of AML-M4 with 57.73% gating.
  
  
  CONCLUSIONS
  Fact that gingival alterations are sometimes the first manifestations of the disease implies that dental professionals must be sufficiently familiarized with the clinical manifestations of systemic diseases. The timely referral by the general dentist for a suspicious lesion provided an early diagnosis and early intervention reducing the patient morbidity.
authors.affiliation: Division of Periodontology, Armed Forces Medical College Pune India.
authors.forename: Mechery
authors.initials: M
authors.lastname: Reenesh
authors.affiliation: Division of Periodontology, Armed Forces Medical College Pune India.
authors.forename: Singh
authors.initials: S
authors.lastname: Munishwar
authors.affiliation: Department of Dental Surgery, Armed Forces Medical College Pune India.
authors.forename: Saroj Kumar
authors.initials: SK
authors.lastname: Rath
keywords: acute myeloid leukemia; flow cytometry; gingival hyperplasia.