Open AccessCryptic PML-RARα positive acute promyelocytic leukemia with unusual morphology and cytogenetics
Author(s) -
Manu Goyal,
Palanki Satya Dattatreya,
Irawathy Goud,
Sudha S Murthy
Publication year - 2010
Publication title -
indian journal of pathology and microbiology/indian journal of pathology and microbiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.217
H-Index - 31
eISSN - 0974-5130
pISSN - 0377-4929
DOI - 10.4103/0377-4929.72097
Subject(s) - acute promyelocytic leukemia , chromosomal translocation , cytogenetics , biology , immunophenotyping , karyotype , fluorescence in situ hybridization , myeloid leukemia , leukemia , derivative chromosome , cancer research , microbiology and biotechnology , acute leukemia , genetics , chromosome 15 , chromosome , retinoic acid , flow cytometry , cell culture , gene
Acute Promyelocytic Leukemia (APL) is different from other forms of acute myeloid leukemia (AML), to the reason being the potential devastating coagulopathy and the sensitivity to all-trans retinoic acid (ATRA) and arsenic trioxide (As 2 O 3 ). We hereby present a case of APL, morphologically distinct from the hypergranular APL; however, the flow cytometry revealed a characteristic phenotype showing dim CD45, bright CD13, bright CD33 and dim CD117 positivity. These were negative for CD34, HLA-DR, B-lymphoid and T-lymphoid lineage markers. Conventional cytogenetics revealed a distinct karyotype of a male with translocation t(4;15)(q34.2:q26.3). However, interphase fluorescence-in-situ hybridization (FISH) revealed PML/RARA fusion signal on chromosome 15 in 90% cells. The cryptic translocations may be missed on conventional cytogenetics, however, need to be picked by other techniques as FISH.