Enunciado A 57-year-old female patient, Who was Born and resident in Belo Horizonte, presents with hyporexia, progressive weight loss, prostration, persistent abdominal pain and episodic fever for the last 18 months. Previous laboratory evaluation revealed pancytopenia, elevated liver enzymes and hypoalbuminemia. She reported having dogs and a poultry-yard at home. Findings on examination: pale mucosa, flaky scaling skin, decreased skin turgor and elasticity, a palpable spleen (Boyd type-II) and no lymph node enlargement or fever. Mielogram (bone marrow aspirate) Question:Based on the clinical scenario and images provided, which is the most likely diagnosis? Multiple myeloma Chronic myelomatous leukemia Visceral leishmaniasis Chronic septicemic salmonellosis Time is Up! Time's up
