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KMID : 0366220050400020120
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Korean Journal of Hematology
2005 Volume.40 No. 2 p.120 ~ p.123
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A Case of Promyelocytic Leukemia with Basophil-like Granules
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Jun Kyung-Ran
Chi Hyun-Sook
Park Chan-Jeoung
Jang Sung-Su
Lee Kyoo-Hyung
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Abstract
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According to FAB classification, two main cytological subtypes are recognized: classical hypergranular and microgranular variant. However, other morphological variants were reported in the literature. So careful examination is needed for diagnosis of acute promyelocytic leukemia (APL). We report here an APL variant case with basophil-like granules of 65 year-old woman admitted due to high fever. The peripheral blood showed blasts and increased basophils. Bone marrow smear showed leukemic blasts with irregular nuclei and coarse basophil-like granules in the cytoplasm. Cytoplasmic vacuoles were also noted, but Auer rod was not found. Blasts had positivity on MPO, tryptase and toluidine blue. Immunophenotype revealed myeloid lineage with aberrant expression of CD2 and CD7. Karyotype was t(15;17)(q22;q12) in 17 metaphases out of 20. The RT-PCR was positive for long form PML/RARα transcripts. Four weeks after chemotherapy, her bone marrow findings were in complete remission status and karyotype was converted to normal. Basophil-like granules in blasts and promyelocytes had been decreased in the course of all-transretinoic acid (ATRA) treatment. Chimeric transcript of PML/RARα was converted to negative after consolidation chemotherapy.
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KEYWORD
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Leukemia, Promyelocytic, Acute, Variant, Basophils
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