Hypergranular promyelocytic leukemia (APL): cytogenetic and ultrastructural
specificity
JR Testa, HM Golomb, JD Rowley, JW Vardiman and DL Sweet
Cytogenetic and ultrastructural findings were important diagnostic
indicators of hypergranular promyelocytic leukemia (APL) in a patient whose
bone marrow morphology appeared, by light microscopy, to be similar to that
in acute myeloblastic leukemia (AML) with maturation. Peripheral blood
smears and bone marrow specimens examined by light microscopy showed few
cells with the numerous coarse, azurophilic granules typical of APL.
Cytogenetic analyses, with several banding techniques, of cells from bone
marrow and unstimulated peripheral blood revealed the 15;17 translocation,
which has been observed only in APL. A reinterpretation of the reciprocal
translocation, based on R banding, suggests that the breakpoints are distal
to q24 in No. 15 and at or near the junction of q21 and q22 in No. 17. In
addition, the patient had disseminated intravascular coagulation. The
characteristic morphology of granules seen in APL was observed in this case
only when transmission electron microscopy was used, since the granules
were quite small. Since treatment for AML differs from that for APL,
identification of the 15;17 translocation and ultrastructural evidence of
granules represent valuable diagnostic aids for APL.
Volume 52,
Issue 2,
pp. 272-280,
08/01/1978
Copyright © 1978 by The American Society of Hematology
