GRANULAR ALL IN ADULT MALE: MASQUERADING AS AML
Surekha Yadav*, Vijay Kumar, A.S. Nigam, Sadhana Marwah and Neel Kamal
ABSTRACT
The presence of cytoplasmic granules in the blasts cells is a one of the main accepted and widely used morphological criteria to diagnose acute myeloid leukemia. A case of Acute lymphoblastic leukemia to have numerous cytoplasmic granules in the blasts is rare and can easily be misdiagnosed as acute myeloid leukemia. We describe a rare case of hyper-granular precursor B-cell acute lymphoblastic leukemia (ALL) in an adult male expressing CD10, CD19, TdT, HLA-DR, CD22, CD34 while negative for CD33, CD14, CD64, CD7, CD5, cMPO, and CD117. There can be chances of erroneous typing of granular ALL as AML when the limited antibody panel is used based on the basis of morphology. Hence it is important to be aware of such rare entity and to confirm the accurate lineage of acute leukemia by using a comprehensive antibody panel for immunophenotypic analysis.
Keywords: Acute lymphoblastic leukaemia (ALL), Acute Myeloid Leukaemia (AML), APML, Immunophenotyping, Cytoplasmic Granules.
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