Cryptic PML-RARα positive acute promyelocytic leukemia with unusual morphology and cytogenetics

Cryptic PML-RARα positive acute promyelocytic leukemia with unusual morphology and cytogenetics

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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 here 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 fleshlight automatique T-lymphoid lineage markers.

Conventional cytogenetics revealed a distinct karyotype of a male with translocation t(4;15)(q34.2:q26.3).

However, interphase florescence-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.