Indian Journal of Pathology and Microbiology
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Year : 2012  |  Volume : 55  |  Issue : 4  |  Page : 574-577

CD34 positive-microgranular variant of acute promyelocytic leukemia in a child

1 Department of Molecular Biology, R & D, Triesta Reference Laboratory, HCG, Bangalore, Karnataka, India
2 Department of Paediatric Oncology, Health Care Global Enterpreises, Bangalore, Karnataka, India

Correspondence Address:
Ashwini R Nargund
E-204, Purva Fairmont Apartments, Parangipalya, Bangalore, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0377-4929.107828

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Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML) in which abnormal promyelocytes predominate. APL is rare in children (approximately 10% of childhood AML) and is characterized by a higher incidence of hyperleukocytosis, an increased incidence of microgranular morphology, the presence of balanced t(15;17)(q22;q11.2-12) translocation, and more frequent occurrence of the PML-RARα isoforms bcr 2 and bcr 3 compared to adults. The cytomorphology of microgranular variant blasts is obviously different from AML M3 blasts; these cells have a nongranular or hypogranular cytoplasm or contain fine dust-like cytoplasmic azurophil granules that may not be apparent by light microscopy. This case report emphasizes the importance of a high index of suspicion for the diagnosis of APL, the hypogranular variant in particular. They are responsive to differentiation therapy with all trans-retinoic acid and complete remission in seen in >80% cases.

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