Acute promyelocytic leukemia hypogranular variant

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Acute promyelocytic leukemia hypogranular variant

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Author: Imad Karam, MD; Armine Bagdasaryan, MD; Leen Khoury, MD; Rachelle Hamadi, MD; Mohan Preet, MD; Aye Mon Thida, MD
Category: Myeloid Neoplasms and acute leukemia (WHO 2016) > Acute Myeloid Leukemia > Acute Myeloid Leukemia with recurrent genetic abnormalities > AML with t(15;17)(q22;q12); PML-RARA (and variants)
Published Date: 10/16/2024

90-year-old male with a medical history of atrial fibrillation, spinal stenosis, and congestive heart failure presented to the emergency department with generalized weakness and decreased appetite of 5 days duration. Complete blood count test showed an elevated white blood cell count of 45000 K/ul; and platelet count of 21000 K/ul. Blasts were seen on the differential. Peripheral smear was reviewed which was significant for abnormally appearing promyelocytes with abnormally folded nuclei and hypogranular cytoplasm. Fluorescence in situ hybridization was significant for PML-RARA (t15;17) in 81% of the cells which is in favor of Acute Promyelocytic Leukemia (APL)

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